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 spacerPang, 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).