THE EFFECTIVENESS OF THE FUNCTIONAL ARTICULATING SPACER FOR TWO-STAGE REVISIONS FOR PROSTHETIC JOINT INFECTIONS: A CASE SERIES STUDY FROM SOUTHLAND HOSPITAL

Introduction The optimal management of prosthetic joint infections (PJI) is undecided. In two-stage revisions, multiple designs of spacers have been described, but the optimal spacer is undecided. The objective of this study is to explore the survivorship of the functional articulating spacer within the concept of a 1.5-stage revision. Methods A prospective case series study is performed, cases extracted from our departmental database starting from 2019. Primary outcome is survival of 1.5 implants, with the endpoint being revision of components. Results 8 patients fit inclusion criteria; one had early failure of components managed with a second 1.5 stage procedure, thus 9 cases for analysis, 5 hips and 4 knees, 5 male and 3 female. At revision, the average age is 63.8 and BMI 39.8. The most common organism is staphylococcus species. 3 of 3 low functioning patients have the 1.5 stage implant in-situ, mean time of 65.7 months since implantation. 3 of 5 high functioning patients are at 44.7 months. 2 of 5 high functioning patients were revised to a second stage implant at 21 and 65 months. The mean prospective survival of the 1.5 stage implants is 49 months. Discussion PJI remains a huge burden accounting for 15% and 30% of revisions of THA and TKA. The 1.5 stage revision allows patients to have one operation with equivalent outcomes up to the mid-term. In those of high demand, this allows a more stable implant and reimplantation at a much later stage under a better environment; those of low physical demand, this may eliminate the necessity for a second stage revision, reducing morbidity and improving cost effectiveness. Conclusion The 1.5 stage revision is an effective way of managing PJI.