{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T08:12:45Z","timestamp":1793261565381,"version":"4.5.0"},"reference-count":41,"publisher":"Elsevier BV","issue":"3","license":[{"start":{"date-parts":[[2020,3,1]],"date-time":"2020-03-01T00:00:00Z","timestamp":1583020800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,3,1]],"date-time":"2020-03-01T00:00:00Z","timestamp":1583020800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["arthroplastyjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Arthroplasty"],"published-print":{"date-parts":[[2020,3]]},"DOI":"10.1016\/j.arth.2019.10.036","type":"journal-article","created":{"date-parts":[[2020,2,8]],"date-time":"2020-02-08T15:51:37Z","timestamp":1581177097000},"page":"S45-S49","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":3,"special_numbering":"S","title":["Do Antibiotic-Impregnated Intramedullary Dowels Assist in Eradicating Infection in Total Knee Arthroplasty? Pro"],"prefix":"10.1016","volume":"35","author":[{"given":"Brandon H.","family":"Naylor","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giles R.","family":"Scuderi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.arth.2019.10.036_bib1","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.arth.2012.02.022","article-title":"Economic burden of periprosthetic joint infection in the United States","volume":"27","author":"Kurtz","year":"2012","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2019.10.036_bib2","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1007\/s11999-009-1013-5","article-title":"Prosthetic joint infection risk after TKA in the Medicare population","volume":"468","author":"Kurtz","year":"2010","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2019.10.036_bib3","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/j.arth.2017.09.021","article-title":"Revision total knee arthroplasty for periprosthetic joint infection is associated with increased postoperative morbidity and mortality relative to noninfectious revisions","volume":"33","author":"Boddapati","year":"2018","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2019.10.036_bib4","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1097\/00003086-198911000-00010","article-title":"The results of spacer block technique in revision of infected total knee arthroplasty","volume":"248","author":"Booth","year":"1989","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2019.10.036_bib5","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1007\/s11999-015-4408-5","article-title":"Can good infection control be obtained in one-stage exchange of the infected TKA to a rotating hinge design? 10-year results","volume":"474","author":"Zahar","year":"2016","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2019.10.036_bib6","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1007\/s11999-013-3294-y","article-title":"Single- or two-stage revision for infected total hip arthroplasty? A systematic review of the literature","volume":"472","author":"Leonard","year":"2014","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2019.10.036_bib7","doi-asserted-by":"crossref","first-page":"994","DOI":"10.1007\/s11999-010-1644-6","article-title":"Intraoperative molds to create an articulating spacer for the infected knee arthroplasty","volume":"469","author":"Van Thiel","year":"2011","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2019.10.036_bib8","doi-asserted-by":"crossref","first-page":"245","DOI":"10.4055\/cios.2011.3.3.245","article-title":"The modified static spacers using antibiotic-impregnated cement rod in two-stage revision for infected total knee arthroplasty","volume":"3","author":"Yoo","year":"2011","journal-title":"Clin Orthop Surg"},{"key":"10.1016\/j.arth.2019.10.036_bib9","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1097\/01.blo.0000201161.52196.c5","article-title":"A\u00a0technique for intraoperative construction of antibiotic spacers","volume":"445","author":"Ha","year":"2006","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2019.10.036_bib10","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1302\/0301-620X.82B6.0820807","article-title":"The PROSTALAC functional spacer in two-stage revision for infected knee replacements","volume":"82","author":"Haddad","year":"2000","journal-title":"J\u00a0Bone Joint Surg Br"},{"key":"10.1016\/j.arth.2019.10.036_bib11","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/j.arth.2011.04.021","article-title":"Intramedullary rod and cement static spacer construct in chronically infected total knee arthroplasty","volume":"27","author":"Kotwal","year":"2012","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2019.10.036_bib12","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1097\/01.blo.0000149241.77924.01","article-title":"Treatment of infected total knee arthroplasty using an articulating spacer: 2- to 12-year experience","volume":"430","author":"Hofmann","year":"2005","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2019.10.036_bib13","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1016\/j.arth.2007.04.028","article-title":"Antibiotic-loaded cement articulating spacer for 2-stage reimplantation in infected total knee arthroplasty. A simple and economic method","volume":"22","author":"Hsu","year":"2007","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2019.10.036_bib14","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1007\/s00264-005-0670-6","article-title":"Pre-formed articulating knee spacer in two-stage revision for the infected total knee arthroplasty","volume":"29","author":"Pitto","year":"2005","journal-title":"Int Orthop"},{"key":"10.1016\/j.arth.2019.10.036_bib15","doi-asserted-by":"crossref","first-page":"S427","DOI":"10.1016\/j.arth.2018.09.027","article-title":"Hip and knee section, treatment, two-stage exchange spacer-related: proceedings of international consensus on orthopedic infections","volume":"34","author":"Abdel","year":"2019","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2019.10.036_bib16","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1016\/j.arth.2013.08.013","article-title":"Articulating vs. static antibiotic impregnated spacers in revision total knee arthroplasty for sepsis. A systematic review","volume":"29","author":"Guild","year":"2014","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2019.10.036_bib17","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1016\/j.arth.2013.07.041","article-title":"Systematic review comparing static and articulating spacers used for revision of infected total knee arthroplasty","volume":"29","author":"Pivec","year":"2014","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2019.10.036_bib18","doi-asserted-by":"crossref","first-page":"2461","DOI":"10.1016\/j.arth.2019.05.022","article-title":"Do antibiotic intramedullary dowels assist in eradicating infection in two-stage resection for septic total knee arthroplasty?","volume":"19","author":"Zielinski","year":"2019","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2019.10.036_bib19","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1128\/mBio.00415-18","article-title":"Novel insights into Staphylococcus aureus deep bone infections: the involvement of osteocytes","volume":"9","author":"Yang","year":"2018","journal-title":"MBio"},{"key":"10.1016\/j.arth.2019.10.036_bib20","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1007\/s12178-018-9500-5","article-title":"New innovations in the treatment of PJI and biofilms\u2014clinical and preclinical topics","volume":"11","author":"Taha","year":"2018","journal-title":"Curr Rev Musculoskelet Med"},{"key":"10.1016\/j.arth.2019.10.036_bib21","doi-asserted-by":"crossref","first-page":"2505","DOI":"10.1016\/j.arth.2017.03.051","article-title":"Poor outcomes of irrigation and debridement in acute periprosthetic joint infection with antibiotic-impregnated calcium sulfate beads","volume":"32","author":"Flierl","year":"2017","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2019.10.036_bib22","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1097\/00003086-199310000-00014","article-title":"A comparison of gentamicin-impregnated polymethylmethacrylate bead implantation to conventional parenteral antibiotic therapy in infected total hip and knee arthroplasty","volume":"295","author":"Nelson","year":"1993","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2019.10.036_bib23","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1177\/112070000701700405","article-title":"Antibiotic distribution in a bone cement spacer model","volume":"17","author":"Shiramizu","year":"2007","journal-title":"Hip Int"},{"key":"10.1016\/j.arth.2019.10.036_bib24","doi-asserted-by":"crossref","first-page":"1946","DOI":"10.2106\/JBJS.L.00014","article-title":"Increasing the elution of vancomycin from high-dose antibiotic-loaded bone cement: a novel preparation technique","volume":"94","author":"Amin","year":"2012","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2019.10.036_bib25","doi-asserted-by":"crossref","first-page":"871","DOI":"10.2106\/00004623-200704000-00026","article-title":"Antibiotic-impregnated cement spacers for the treatment of infection associated with total hip or knee arthroplasty","volume":"89","author":"Cui","year":"2007","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2019.10.036_bib26","first-page":"201","article-title":"In vitro elution of tobramycin and vancomycin polymethylmethacrylate beads and spacers from simplex and palacos","volume":"27","author":"Greene","year":"1998","journal-title":"Am J Orthop (Belle Mead NJ)"},{"key":"10.1016\/j.arth.2019.10.036_bib27","doi-asserted-by":"crossref","first-page":"2677","DOI":"10.1007\/s11999-012-2351-2","article-title":"Mixing method affects elution and strength of high-dose ALBC: a pilot study infection","volume":"470","author":"Miller","year":"2012","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2019.10.036_bib28","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1016\/j.arth.2014.12.003","article-title":"The effects of different mixing speeds on the elution and strength of high-dose antibiotic-loaded bone cement created with the hand-mixed technique","volume":"30","author":"Pithankuakul","year":"2015","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2019.10.036_bib29","doi-asserted-by":"crossref","first-page":"727","DOI":"10.5435\/JAAOS-D-17-00305","article-title":"Antibiotic-laden bone cement in primary and revision hip and knee arthroplasty","volume":"26","author":"Gandhi","year":"2018","journal-title":"J\u00a0Am Acad Orthop Surg"},{"key":"10.1016\/j.arth.2019.10.036_bib30","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1097\/00003086-199708000-00013","article-title":"Infected total knee arthroplasty; two-stage reimplantation with a gastrocnemius rotational flap","volume":"341","author":"McPherson","year":"1997","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2019.10.036_bib31","first-page":"1247","article-title":"Two-stage revision hip arthroplasty for infection with a custom-made, antibiotic-loaded, cement prosthesis as an interim spacer","volume":"56","author":"Hsieh","year":"2004","journal-title":"J\u00a0Trauma"},{"key":"10.1016\/j.arth.2019.10.036_bib32","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1016\/j.arth.2007.04.009","article-title":"Functional advantage of articulating versus static spacers in 2-stage revision for total knee arthroplasty infection","volume":"22","author":"Freeman","year":"2007","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2019.10.036_bib33","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1016\/j.arth.2012.01.027","article-title":"Preformed articulating knee spacers in 2-stage total knee revision arthroplasty. Minimum 2-year follow-up","volume":"27","author":"Wan","year":"2012","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2019.10.036_bib34","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1007\/s11999-011-2095-4","article-title":"Minimizing dynamic knee spacer complications in infected revision arthroplasty","volume":"470","author":"Johnson","year":"2012","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2019.10.036_bib35","doi-asserted-by":"crossref","first-page":"2487","DOI":"10.2106\/JBJS.E.01126","article-title":"Antibiotic-loaded bone cement for\u00a0infection prophylaxis in total joint replacement","volume":"88","author":"Jiranek","year":"2016","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2019.10.036_bib36","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1097\/00003086-199712000-00020","article-title":"Bone loss associated with the use of spacer blocks in infected total knee arthroplasty","volume":"345","author":"Calton","year":"1997","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2019.10.036_bib37","doi-asserted-by":"crossref","first-page":"1462","DOI":"10.1016\/j.arth.2019.03.053","article-title":"Management of chronically infected total knee arthroplasty with severe bone loss using static spacers with intramedullary rods","volume":"34","author":"Hipfl","year":"2019","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2019.10.036_bib38","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/j.arth.2008.03.017","article-title":"Initial results of managing severe bone loss in infected total joint arthroplasty using customized articulating spacers","volume":"24","author":"Incavo","year":"2009","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2019.10.036_bib39","first-page":"422","article-title":"Spacer-related problems in two-stage revision knee arthroplasty","volume":"79","author":"Struelens","year":"2013","journal-title":"Acta Orthop Belg"},{"key":"10.1016\/j.arth.2019.10.036_bib40","doi-asserted-by":"crossref","first-page":"2749","DOI":"10.1016\/j.arth.2019.06.021","article-title":"Two-stage exchange arthroplasty for periprosthetic joint infection: the rate and reason for the attrition after the first stage","volume":"19","author":"Wang","year":"2019","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2019.10.036_bib41","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1016\/j.arth.2018.02.078","article-title":"The 2018 definition of periprosthetic hip and knee infection: an evidence-based and validated criteria","volume":"33","author":"Parvizi","year":"2018","journal-title":"J\u00a0Arthroplasty"}],"container-title":["The Journal of Arthroplasty"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0883540319310137?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0883540319310137?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:26:58Z","timestamp":1760120818000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0883540319310137"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3]]},"references-count":41,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,3]]}},"alternative-id":["S0883540319310137"],"URL":"https:\/\/doi.org\/10.1016\/j.arth.2019.10.036","relation":{},"ISSN":["0883-5403"],"issn-type":[{"value":"0883-5403","type":"print"}],"subject":[],"published":{"date-parts":[[2020,3]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Do Antibiotic-Impregnated Intramedullary Dowels Assist in Eradicating Infection in Total Knee Arthroplasty? Pro","name":"articletitle","label":"Article Title"},{"value":"The Journal of Arthroplasty","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.arth.2019.10.036","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2019 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}