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2% ~ -5%, -1% ~ -4%, and +1% ~ -2% in four physiological motions, respectively. For thePhysio-L (soft) model, ROM varied by 0% ~ -5%, -2% ~ -5%, -0% ~ -5%, and -9% ~ -11% infour physiological motions, respectively. For the physio-L (hard) model, ROM varied by +4% ~-2%, +8% ~ -5%, +1 ~ -5%, and +11% ~ -6% in four physiological motions, respectively.As seemed in the simulation, the behavior of Physio-L (both soft and hard) is similar to that ofintact model under flexion and extension, but not in axial rotation. In addition, Physio-L (hard)model is more similar to intact model as compared to Physio-L (soft) model.FiguresFriday, October 8, 2010, 14:00-14:50Session A14: Complication ManagementCustom Made Hinged Spacers in Revision Knee Surgery for Patients WithInfection, Bone Loss and Instability*Simon Macmull - Royal National Orthopaedic Hospital - Barnet, UKWill Bartlett - Royal National Orthopaedic Hospital - London, UKJonathan Miles - Royal National Orthopaedic Hospital - London, UKGordon Blunn - Royal National Orthopaedic Hospital - London, UKRob Pollock - Royal National Orthopaedic Hospital - London, UKRichard Carrington - Royal National Orthopaedic Hospital - London, UKJohn Skinner - Royal National Orthopaedic Hospital Trust - Stanmore, UKSteve Cannon - Royal National Orthopaedic Hospital - London, UKTim Briggs - . - London, UK*Email: simonmacmull@hotmail.comPolymethyl methacrylate spacers are commonly used during staged revision knee arthroplastyfor infection. In cases with extensive bone loss and ligament instability, such spacers may notpreserve limb length, joint stability and motion.We report a retrospective case series of 19 consecutive patients using a custom-made cobaltchrome hinged spacer with antibiotic-loaded cement. The “SMILES spacer” was used at firststagerevision knee arthroplasty for chronic infection associated with a significant bone loss dueto failed revision total knee replacement in 11 patients (58%), tumour endoprosthesis in fourpatients (21%), primary knee replacement in two patients (11%) and infected metalworkfollowing fracture or osteotomy in a further two patients (11%). Mean follow-up was 38 months(range 24–70). In 12 (63%) patients, infection was eradicated, three patients (16%) hadpersistent infection and four (21%) developed further infection after initially successful secondstagesurgery. Above knee amputation for persistent infection was performed in two patients.In this particularly difficult to treat population, the SMILES spacer two-stage technique hasdemonstrated encouraging results and presents an attractive alternative to arthrodesis oramputation.file:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]