We have located links that may give you full text access.
JOURNAL ARTICLE
MULTICENTER STUDY
RESEARCH SUPPORT, N.I.H., EXTRAMURAL
Do dynamic cement-on-cement knee spacers provide better function and activity during two-stage exchange?
Clinical Orthopaedics and related Research 2012 September
BACKGROUND: Implantation of an antibiotic bone cement spacer is used to treat infection of a TKA. Dynamic spacers fashioned with cement-on-cement articulating surfaces potentially facilitate patient mobility and reduce bone loss as compared with their static counterparts, while consisting of a biomaterial not traditionally used for load-bearing articulations. However, their direct impact on patient mobility and wear damage while implanted remains poorly understood.
QUESTIONS/PURPOSES: We characterized patient activity, surface damage, and porous structure of dynamic cement-on-cement spacers.
METHODS: We collected 22 dynamic and 14 static knee antibiotic cement spacers at revision surgeries at times ranging from 0.5 to 13 months from implantation. For these patients, we obtained demographic data and UCLA activity levels. We characterized surface damage using the Hood damage scoring method and used micro-CT analysis to observe the internal structure, cracking, and porosity of the cement.
RESULTS: The average UCLA score was higher for patients with dynamic spacers than for patients with static spacers, with no differences in BMI or age. Burnishing was the only prevalent damage mode on all the bearing surfaces. Micro-CT analysis revealed the internal structure of the spacers was porous and highly inhomogeneous, including heterogeneous dispersion of radiopaque material and cavity defects. The average porosity was 8% (range, 1%-29%) and more than ½ of the spacers had pores greater than 1 mm in diameter.
CONCLUSIONS: Our observations suggest dynamic, cement-on-cement spacers allow for increased patient activity without catastrophic failure. Despite the antibiotic loading and internal structural inhomogeneity, burnishing was the only prevalent damage mode that could be consistently classified with no evidence of fracture or delamination. The porous structure of the spacers varied highly across the surfaces without influencing the material failure.
QUESTIONS/PURPOSES: We characterized patient activity, surface damage, and porous structure of dynamic cement-on-cement spacers.
METHODS: We collected 22 dynamic and 14 static knee antibiotic cement spacers at revision surgeries at times ranging from 0.5 to 13 months from implantation. For these patients, we obtained demographic data and UCLA activity levels. We characterized surface damage using the Hood damage scoring method and used micro-CT analysis to observe the internal structure, cracking, and porosity of the cement.
RESULTS: The average UCLA score was higher for patients with dynamic spacers than for patients with static spacers, with no differences in BMI or age. Burnishing was the only prevalent damage mode on all the bearing surfaces. Micro-CT analysis revealed the internal structure of the spacers was porous and highly inhomogeneous, including heterogeneous dispersion of radiopaque material and cavity defects. The average porosity was 8% (range, 1%-29%) and more than ½ of the spacers had pores greater than 1 mm in diameter.
CONCLUSIONS: Our observations suggest dynamic, cement-on-cement spacers allow for increased patient activity without catastrophic failure. Despite the antibiotic loading and internal structural inhomogeneity, burnishing was the only prevalent damage mode that could be consistently classified with no evidence of fracture or delamination. The porous structure of the spacers varied highly across the surfaces without influencing the material failure.
Full text links
Related Resources
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app