title: Two-stage revision of infected total knee arthroplasty using a distraction spacer.
abstract: BACKGROUND
  The infection of a total knee arthroplasty (TKA) has remained as one of the most devastating potential complications. In this context we developed a new technique that keeps the spacer in distraction during the cementation process to achieve better weight-bearing stability.
  
  
  METHODS
  We present a case of a 75-year-old male patient, who was treated in our hospital with an infected total knee replacement (TKR) using the distraction spacer. The operative technique includes the removal of the infected prosthesis after radical debridement. Then two carbon rods were inserted overlapping 2-3 cm in the medulla of the tibia and femur. Afterwards an external fixateur with distraction module is attached with two Schanz screws into the distal femur and the proximal tibia. The cementation process was performed under distraction. After hardening of the cement the external fixateur and the Schanz screws are then removed.
  
  
  RESULTS
  Postoperatively the patient was mobilized with full weight-bearing using an extension splint. The antibiotic therapy was continued for five weeks. After sterile puncture, the reimplantation was performed using a Zimmer-Rotating-Hinge-Knee without any complications.
  
  
  CONCLUSIONS
  This method allows cement hardening without micromovements and early mobilization with partial full weight bearing and prevents the contraction of the capsule and the ligaments during the prosthesis-free period, preparing the knee for a secondary TKA or an intramedullary arthrodesis with a titanium stem.
authors: Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil GmbH, Bochum, Ruhr University, Bochum, Germany. mcitak@gmx.de
authors: Mustafa
authors: M
authors: Citak
authors: Jan
authors: J
authors: Gessmann
authors: Tobias
authors: T
authors: Fehmer
authors: Otto
authors: O
authors: Russe
authors: Thomas A
authors: TA
authors: Schildhauer
authors: Dominik
authors: D
authors: Seybold