Abstract
This case involved an elderly man with a failed infected total hip replacement (THA), massive acetabular and femoral bone loss, and extension of the infection to involve his native degenerative knee. This ultimately required radical debridement with removal of the entire femur, all the components, and prior polymethyl methacrylate (PMMA). The challenge was to construct a temporizing functional PMMA spacer that would simultaneously replace a completely resected femur, act as a functional articulating device at the hip, and allow immediate weight bearing to restore mobility during the interim between the two stages. Staged reconstruction was made possible using an interim custom antibiotic-impregnated PMMA spacer incorporating a THA stem impaled on a knee fusion intramedullary (IM) nail.
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References and Suggested Reading
Berend KR, Lombardi AV, Mallory TH, Adams JB, Dodds KL (2004) Total femoral arthroplasty for salvage of end-stage prosthetic disease. Clin Orthop Relat Res 427:162–170
Bickels J, Meller I, Henshaw RM, Malawer M (2000) Reconstruction of hip stability after proximal and total femur resections. Clin Orthop Relat Res 375:218–230
Sherman SL, Cunneen KP, Walcott-Sapp S, Brause B, Westrich GH (2008) Custom total femur spacer and second-stage total femur arthroplasty as a novel approach to infection and periprosthetic fracture. J Arthroplasty 23:781–786
Tetsworth K (2003) Infection after total knee arthroplasty: evaluation and treatment. Curr Opin Orthop 14:45–51
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© 2015 Her Majesty the Queen in Right of Australia, as represented by Queensland Health
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Kent, S., Tetsworth, K. (2015). Case 50: Staged Revision of a Chronic Infected Ipsilateral THA and TKA Using an Antibiotic Laden PMMA Functional Spacer Incorporating a Knee Fusion Nail. In: Rozbruch, S., Hamdy, R. (eds) Limb Lengthening and Reconstruction Surgery Case Atlas. Springer, Cham. https://doi.org/10.1007/978-3-319-18020-5_297
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DOI: https://doi.org/10.1007/978-3-319-18020-5_297
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Publisher Name: Springer, Cham
Print ISBN: 978-3-319-18019-9
Online ISBN: 978-3-319-18020-5
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