A patient undergoes two-stage revision for chronic PJI after total knee replacement. Which antibiotic-loaded spacer type is preferred to maintain joint space AND allow knee motion during the interval period?
- A Articulating spacer allowing range of motion between stages ✓
- B Static block spacer made of solid PMMA without joint articulation
- C External fixator with distraction arthroplasty
- D Resection arthroplasty with no spacer until culture results confirmed
Explanation
Articulating antibiotic-loaded cement spacers are preferred in two-stage revision TKR because they allow knee flexion/extension during the interval, maintain soft-tissue tension, prevent scar contracture, and facilitate easier reimplantation. They also provide high local antibiotic concentration. Static spacers control infection comparably but result in stiffness and more complex second-stage surgery. Articulating spacers can be fabricated using a commercial mold or using modular components. External fixator and resection arthroplasty are not standard two-stage revision techniques.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.