Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Arthroplasty - Knee
Abstract number: 24378
THE MODIFIED STATIC SPACERS USING ANTIBIOTIC-IMPREGNATED
CEMENT ROD IN TWO-STAGE REVISION FOR INFECTED TOTAL KNEE
ARTHROPALSTY. -TECHNICAL NOTE-
Ju-Hyung YOO 1 , Chang-Dong HAN 2 , Hyun-Cheol OH 1
1 National Health Insurance Corporation Ilsan Hospital Department of Orthopaedic
Surgery, Gyeonggi-do (KOREA), 2 Yonsei Univeristy College of Medicine, Department
of Orthopaedic Surgery, Seoul (KOREA)
We report a novel two-stage exchange arthroplasty technique using an antibioticimpregnated
cement intramedullary rod for the treatment of infections after total knee
arthroplasty. An antibiotic-impregnated cement intramedullary rod can be easily
prepared during surgery; a 36Fr-diameter straight thoracic catheter and a 3.0mmdiameter,
22cm-length Steinmann pin were prepared for manufacturing the rod.
Vancomycin (1g) was then added to the bone cement. At the late liquid stage of the
cement, the antibiotic-impregnated cement was poured into the 50cc enema syringe.
The Steinmann pin was inserted into the tube, and the prepared cement was
delivered through the tube. The tube was rolled gently to straighten the straight rod.
After the cement hardened, the tube was removed from the cement rod using a
surgical knife. Finally, a 9mm-diameter, 22cm-length cement rod was obtained. The
rod was inserted into the femur and tibia. The proximal medullary canal of the tibia
was filled with antibiotic-impregnated cement up to the surface of the proximal tibia
while proper anatomic alignment and joint space was maintained by the assistant.
Then same procedure was then carried out for distal femur. The space between the
cement of the distal femur and proximal tibia was filled with more antibioticimpregnated
cement. The rod provides additional stability to the knee to maintain the
normal mechanical axis. In addition, there is less pain between prosthesis removal
and the later reimplantation. Less soft tissue contracture, less scar adhesion, easy
removal of cement intramedullary nail and successful infection control are
advantages of this technique.
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