ObjectiveTo evaluate the clinical efficacy of the parallel osteotomy combined with a "prosthetic spacer" in the treatment of Stage IV septic arthritis (SA) of the knee, and to provide a staged treatment strategy that effectively controls infection while maximizing joint function preservation.Methods A prospective analysis was conducted on 23 patients diagnosed with knee SA at the joint department of Xi'an Honghui Hospital from 2020.9 to 2023.9.All patients underwent parallel osteotomy with a "joint spacer", categorized into a prosthetic group (12 cases, using CR femoral condyles and tibial polyethylene liners) and a bone cement group (11 cases, using cement-molded spacers).operative time, blood loss, preoperative/postoperative pain VAS scores, postoperative KSS scores, range of motion (ROM), 1-year infection recurrence rates, and secondary surgery rate were recorded.Data were analyzed using SPSS 21.0 (P 0.05), and the prosthetic group had a lower rate of secondary surgery (P < 0.05). ConclusionThe parallel osteotomy combined with a "prosthetic spacer" is a viable option for severe knee SA.This approach effectively controls infection and preserves joint function, warranting broader clinical adoption.Fig. 1 (Abstract O1).The specific operation process and steps of parallel osteotomy.In Fig. A, it can be seen that SAK has invaded the cartilage, and there is obvious joint destruction.Fig. B, self-made parallel osteotomy; Fig. C-E.Parallel osteotomy is used to make flexion and extension Spaces.Fig. F, complete effect of osteotomy
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