The Knee, ISSN: 1873-5800, Vol: 22, Issue: 5, Page: 440-2

Treatment of infected nonunion total knee arthroplasty periprosthetic fracture using a stemmed articulating spacer

Pang, Hee-Nee; Seah, Renyi Benjamin; MacDonald, Steven J


We present a case of multifocal infection involving the left total hip replacement and the right total knee replacement of a patient, further complicated by an infected non-union of a periprosthetic fracture of the right knee. This required the unique simultaneous management of both infection eradication and fracture stabilization in the knee.


Both sites were treated with a two-stages procedure, including the novel use of a stemmed articulating spacer for the right knee. This spacer was made combining a retrograde humeral nail, coated with antibiotic-impregnated cement, and a pre-formed articulating cement spacer. The patient was able to weight-bear on this spacer.


The fracture went on to unite, and a second stage was performed with the use of stemmed prosthesis and augments. She remains infection free two years after the second stage operation.


The use of a stemmed articulating knee spacer can facilitate infection eradication and fracture stabilization while preserving some motion and weight-bearing ability in the two-stages management of an infected periprosthetic fracture of the knee.

Level of evidence

Level V (Case report).

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