Skip to main content
Log in

Removal and successful re-implantation of a customized interpositional knee device following an early postoperative infection: A case report

  • Case Report
  • Published:
Central European Journal of Medicine

Abstract

We report the first case of early postoperative infection after a medial hemiarthroplasty of the knee with a customized ConforMIS iForma™ interpositional device. The infection was treated successfully by revision surgery with implant removal and antibiotic therapy. Despite the additional diagnosis of rheumatoid arthritis that did not affect the treated knee, the preservation of bony and ligamentous structures enabled a successful re-implantation of another iForma™ implant 9 months later with good clinical results at follow-up examination 1 year postoperatively. This is very much in contrast to the extensive and complex revision surgery, with significant bone loss, in patients with infected unicompartmental or total knee arthroplasties. The iForma™ device may be an alternative treatment option in early and moderate unicompartmental arthritis of the knee, with easy revision with the same type of implant in the rare case of infection.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. MacIntosh D.L., Hemiarthroplasıy of the knee using a space occupying prosthesis for painful varus and valgus deformities. In Proceedings of the Joint Meeting of the Orthopaedic Associations of the English-Speaking World. J. Bone Joint Surg. [Am], 1959, 40, 1431

    Google Scholar 

  2. McKeever D.C., Elliott R.B. Tibial plateau prosthesis. Clin. Orthop. Rel. Res., 1960, 18, 86–95

    Google Scholar 

  3. Scott R.D., Joyce M.J., Ewald F.C., Thomas W.H., McKeever metallic hemiarthroplasty of the knee in unicompartmental degenerative arthritis. Longterm clinical follow-up and current indications. J. Bone Joint Surg. [Am], 1985, 67, 203–207

    CAS  Google Scholar 

  4. Emerson R., Potter T., The use of the McKeever metallic hemiarthroplastsy for unicompartmental arthritis. J. Bone Joint Surg. [Am], 1988, 67, 208–2012

    Google Scholar 

  5. Springer B.D., Scott R.D., Sah A.P., Carrington R., McKeever hemiarthroplasty of the knee in subjects less than sixty years old. J. Bone Joint Surg. [Am], 2006, 88, 366–371

    Article  Google Scholar 

  6. Hastings D.E., Hewitson W.A., Double hemiarthroplasty of the knee in rheumatoid arthritis. A survey of fifty consecutive cases. J. Bone Joint Surg. [Br] 1973, 55, 112–118

    CAS  Google Scholar 

  7. Bailie A.G., Lewis P.L., Brumby S.A., Roy S., Paterson R.S., Campbell D.G., The Unispacer knee implant: Early clinical results. J. Bone Joint Surg. [Br], 2008, 90, 446–450

    Article  CAS  Google Scholar 

  8. Hallock R.H., Fell B.M., Unicompartmental tibial hemiarthroplasty: early results of the UniSpacer knee. Clin. Orthop. Relat. Res., 2003, 416, 154–163

    Article  PubMed  Google Scholar 

  9. Sisto D.J., Mitchell I.L., Unispacer arthroplasty of the knee. J. Bone Joint Surg. [Am], 2005, 87, 1706–1711

    Article  Google Scholar 

  10. Koeck F.X., Perlick L., Luring C., Handel M., Beckmann J., Linhardt O., Grifka J., Leg axis correction with ConforMIS iForma™ (interpositional device) in unicompartmental arthritis of the knee. Int. Orthop., 2008, 33, 955–960

    Article  PubMed  Google Scholar 

  11. Chesney D., Sales J., Elton R., Brenkel I.J,. Infection after knee arthroplasty a prospective study of 1509 cases. J. Arthroplasty, 2008, 23, 355–359

    Article  PubMed  Google Scholar 

  12. Jämsen E., Huotari K., Huhtala H., Nevalainen J., Konttinen Y.T., Low rate of infected knee replacements in a nationwide series—is it an underestimate? Acta Orthop., 2009, 80, 205–212

    Article  PubMed  Google Scholar 

  13. Jämsen E., Huhtala H., Puolakka T., Moilanen T., Risk factors for infection after knee arthroplasty. A register-based analysis of 43,149 cases. J. Bone Joint Surg. [Am], 2009, 91, 38–47

    Article  Google Scholar 

  14. Zimmerli W., Ochsner P.E., Management of infections associated with prosthetic joints. Infection, 2003, 31, 93–102

    Article  Google Scholar 

  15. MacIntosh D.L., Hunter G.A., The use of the hemiarthroplasty prosthesis for advanced osteoarthritis and rheumatoid arthritis of the knee. J. Bone Joint Surg. [Br], 1972, 54, 244–255

    CAS  Google Scholar 

  16. Potter T.A., Weinfeld M.S., Thomas W.H., Arthroplasty of the knee in rheumatoid arthritis and osteoarthritis. A follow-up study after implantation of the McKeever and MacIntosh prostheses. J. Bone Joint Surg. [Am], 1972, 54, 1–24

    CAS  Google Scholar 

  17. Bellamy N., Buchanan W.W., Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J. Rheumatol., 1988, 15, 1833–1840

    CAS  PubMed  Google Scholar 

  18. Whitehouse S.L., Lingard E.A., Katz J.N., Learmonth I.D., Development and testing of a reduced WOMAC function scale. J. Bone Joint Surg. [Br], 2003, 85, 706–711

    CAS  Google Scholar 

  19. Stengel D., Bauwens K., Sehouli J., Ekkernkamp A., Porzsolt F.. Systematic review and meta-analysis of antibiotic therapy for bone and joint infections. Lancet infect dis. 2001, 1, 175–188

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Franz Xaver Koeck.

About this article

Cite this article

Koeck, F.X., Rath, B., Springorum, HR. et al. Removal and successful re-implantation of a customized interpositional knee device following an early postoperative infection: A case report. cent.eur.j.med 5, 442–446 (2010). https://doi.org/10.2478/s11536-009-0135-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2478/s11536-009-0135-1

Keywords

Navigation