Systematic review comparing static and articulating spacers used for revision of infected total knee arthroplasty

The purpose of this systematic review was to compare the outcomes of static to articulating antibiotic spacers used in two-stage revision total knee arthroplasty. 48 reports with a total of 962 articulating spacers (949 patients) and 707 static spacers (688 patients) with a mean 4 year follow-up were identified for this review. Data on clinical function scores, range-of-motion, complications, and re-infection rates were collected on static and articulating spacers. Both groups had similar improvement in Knee Society Scores (83 versus 82 points), however, the articulating spacer groups had significantly higher range-of-motion (100° versus 92°). There was no difference in the re-infection rates, complication rates, or re-operation rates between the two groups. Currently no specific recommendation can be made about the superiority of one type of spacer over the other.