Custom total femur spacer and second-stage total femur arthroplasty as a novel approach to infection and periprosthetic fracture

J Arthroplasty. 2008 Aug;23(5):781-6. doi: 10.1016/j.arth.2007.05.027. Epub 2007 Nov 7.

Abstract

Total femur arthroplasty procedures have previously been used after tumor excision and as a last resort for failed revision arthroplasty. The patient in this case presented with massive loss of femoral bone stock, a periprosthetic fracture, and recurrent Staphylococcus epidermidis infection. A specially designed total femoral spacer impregnated with antibiotics was created for a 2-stage revision procedure that successfully restored functional ability and eradicated the infection. Although 2-stage protocols with spacers have been used to treat persistent infections after hip and knee arthroplasty, this is the first reported instance of the creation of a total femur antibiotic-impregnated cement spacer and subsequent total femoral arthroplasty as a 2-stage protocol at our institution.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Arthroplasty, Replacement, Hip / adverse effects
  • Arthroplasty, Replacement, Hip / instrumentation*
  • Arthroplasty, Replacement, Hip / methods*
  • Combined Modality Therapy
  • Female
  • Femur / diagnostic imaging
  • Femur / microbiology
  • Femur / surgery
  • Fractures, Bone / surgery*
  • Hip Joint / diagnostic imaging
  • Hip Joint / microbiology
  • Hip Joint / surgery
  • Hip Prosthesis / adverse effects*
  • Humans
  • Prosthesis Failure
  • Prosthesis-Related Infections / drug therapy*
  • Prosthesis-Related Infections / microbiology
  • Radiography
  • Reoperation
  • Staphylococcal Infections / drug therapy*
  • Staphylococcal Infections / etiology
  • Staphylococcus epidermidis

Substances

  • Anti-Bacterial Agents