InterSpace Knee, Hip and Shoulder are preformed, articulating, partial load-bearing structures comprised of gentamicin-impregnated PMMA bone cement. InterSpace is indicated for skeletally-mature patients undergoing the first stage of a two-stage revision arthroplasty.11
The spacer’s textured finish increases its surface area, which allows for greater antibiotic release.
- Proven high release formulation and design yields predictable and consistent local antimicrobial activity compared to other treatment options.2,3,5
- Maintains joint space and allows limited mobility with partial weight bearing2*
- Stabilizes or tensions the soft tissues and reduces bone loss between stages, potentially facilitating easier re-implantation during a second-stage procedure3-6
- InterSpace demonstrates functional success rates equivalent to non-infected revisions10
- Shortens operating time2,6
- Stainless steel reinforcing core in Hip and Shoulder Spacers
- Multiple sizing options
Eradication rate at latest follow-up
Peer-reviewed papers at 25 different sites
Months average follow-up
This systematic review provides evidence in favor of the routine use of an industrially, pre-formed spacer loaded with a standardized, relatively low concentration of gentamicin, (and) that in different centers, showed an average infection eradication rate of 96.1 percent at spacer removal and 94.8 percent at the latest follow-up after reimplantation. The systematic review does not support the hypothesis that the antibiotic associations or antibiotic concentrations higher than 1.9 percent are routinely needed for spacers used in two-stage revision surgery.
Study Criteria and Outcomes
The inclusion criteria removed case reports, clinical series with less than 10 patients, duplicate studies and series with a mean follow-up of less than 24 months. The exclusion criteria left 10 papers for a total of 491 spacers implanted at 10 centers.
Infection Control at Spacer Removal 96.1%
Only 19 patients (3.9%) had a persistent infection that required a spacer exchange or resection arthroplasty
Eradication Rate at Latest Follow-up 94.8%
Four hundred and eighty (480) patients underwent the second-stage procedure, of the 480, only 25 patients (5.2%) had an infection at the mean follow-up of 46 months
InterSpace® Tapered Wedge
As the newest addition to the Exactech Spacer family, the InterSpace Tapered Wedge allows surgeons to more conservatively treat patients following a peri-prosthetic joint infection (PJI) of a wedge-style stem.
This modern tapered wedge design helps to more conservatively address a narrow femoral cavity, and the low profile lateral shoulder allows for ease of insertion when implanting the stem.
InterSpace® is produced by Tecres® S.p.A., Italy, and distributed in the United States exclusively by Exactech, Inc.
- Romano CL, Drago L, Logoluso N. Low-dose gentamicin-loaded spacers are effective for two-stage revision. Musculoskeletal Infection Society (MSIS). 2013 July 30.
- Bertazzoni Minelli E, Benini A, Magnan B, Bartolozzi P. Release of gentamicin and vancomycin from temporary human hip spacers in two-stage revision of infected arthroplasty. J Antimicrob Chemother. 2004 Feb;53(2):329-34. Epub 2003 Dec 19.
- Romano CL, Romano D, Logoluso N, Meani E. Aseptic versus total hip arthroplasty revision: comparing the results. Poster presented at the 76th annual American academy of Orthopaedics Surgeons Meeting; 2009 Feb. 25-28; Las Vegas, NV.
- Romano CL, Romano D, Meani E, Logoluso N, Drago L. Two-stage revision surgery with preformed spacers and cementless implants for septic hip arthritis: a prospective, non-randomized cohort study. BMC Infect Dis. 2011 May 16;11:129. doi:10.1186/1471-2334-11-129.
- Pattyn C, De Geest T, Ackerman P, Audenaert E. Preformed gentamicin spacers in two-stage revision hip arthroplasty: functional results and complications. Int Orthop. 2011 Oct; 35 (10): 1471-6. Doi:10.1007/s00264-010-1172-8. Epub 2010 Nov 30.