Management of posttraumatic extensive bone loss and osteomyelitis using a customized articulating knee spacer.
The combination of infection and extensive bone loss presents a challenging reconstructive situation for surgeons performing total knee arthroplasty (TKA). We describe the case of a patient that suffered a grade III open fracture of the tibial plateau and developed a recurrent infection which resulted in loss of the proximal 15 cm of the tibia. Our solution was interim use of custom-made articulating, antibiotic-impregnated spacers followed by a structural tibial allograft and hinged TKA. At 2-year follow-up the patient is infection-free and is able to ambulate without the use of support.
Baylor College of Medicine, Houston, TX, United States.
Robert D
RD
Russell
Stephen J
SJ
Incavo
Michael
M
Klebuc
Kevin
K
Varner
D000328:Adult; D005599:Fractures, Ununited / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D010014:Osteolysis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D010019:Osteomyelitis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D011859:Radiography; D013978:Tibial Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*