Custom total femur spacer and second-stage total femur arthroplasty as a novel approach to infection and periprosthetic fracture.
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.
Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York 10021, USA.
Seth L
SL
Sherman
Kieran Phaeleau
KP
Cunneen
Sarah
S
Walcott-Sapp
Barry
B
Brause
Geoffrey H
GH
Westrich
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery; D050723:Fractures, Bone / Q000601:surgery*; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000382:microbiology; D011859:Radiography; D012086:Reoperation; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000209:etiology; D013212:Staphylococcus epidermidis
D000900:Anti-Bacterial Agents