In two-stage revision arthroplasty for periprosthetic joint infection, the antibiotic-loaded cement spacer performs which of the following additional mechanical roles beyond local antimicrobial delivery?
- A Maintains joint space and soft-tissue tension, facilitating reimplantation exposure ✓
- B Stimulates osteogenesis to fill bone defects before reimplantation
- C Provides permanent weight-bearing support, obviating need for reimplantation in high-risk patients
- D Acts as an osteoconductive scaffold integrating with host bone
Correct answer: A. Maintains joint space and soft-tissue tension, facilitating reimplantation exposure
Explanation
Antibiotic-loaded articulating spacers (PROSTALAC or hand-made) maintain joint space, preserve soft-tissue lengths (especially in the hip, preventing proximal migration of the femur), and allow limited mobilisation between stages. This reduces scar formation and simplifies second-stage reimplantation. They do not provide long-term weight-bearing capacity, do not stimulate osteogenesis, and cement is not osteoconductive.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.