title: Temporary total hip arthroplasty-like spacer for treating an infected periprosthetic femoral fracture using a long stem: A case report.
abstract: BACKGROUND
  Infected periprosthetic femoral fractures are among the most complex and significant complications of total hip arthroplasty (THA). We report the novel use of a temporary THA-like spacer for treating an infected periprosthetic femoral fracture after revision surgery using a long stem.
  
  
  METHODS
  We present a 72-year-old woman sustained a left infected periprosthetic femoral fracture after revi - streptococci in the culture sample. On suspicion of a periprosthetic joint infection, we planned a two-stage procedure. We used a temporary THA-like spacer comprising the removed femoral long stem, which was autoclaved and then reimplanted, and applied a new polyethylene acetabular liner. Both components were cemented in place with antibioticloaded bone cement, without applying strong pressure. Pain control waseasily achieved postoperatively because the fracture had been stabilized early. The THA-like spacer was stable, and allowed a good range of motion without pain. She was allowed to move with a wheelchair and was walk with partial weight bearing without pain. Seven week after the initial THAlike spacer placement, we performed a revision THA after successful control of infection. At the 1-year follow-up, the patient remained free of infection.
  
  
  CONCLUSIONS
  Temporary antibiotic-loaded cement-coated THA-like spacer using a long stem facilitated the eradication of infection, fracture stabilization, and enables partial weight bearing without pain.
authors.affiliation: Department of Orthopaedics, Shiga Medical Center for Adults, 5-4-30 Moriyama, Moriyama, Shiga, Japan. Electronic address: woochan76@hotmail.co.jp.
authors.forename: Youngwoo
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Department of Orthopaedics, Shiga Medical Center for Adults, 5-4-30 Moriyama, Moriyama, Shiga, Japan. Electronic address: QYF07360@nifty.com.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Katsura
authors.affiliation: Department of Orthopaedics, Shiga Medical Center for Adults, 5-4-30 Moriyama, Moriyama, Shiga, Japan. Electronic address: 27@mail.goo.ne.jp.
authors.forename: Nina
authors.initials: N
authors.lastname: Kasahara
authors.affiliation: Department of Orthopaedics, Shiga Medical Center for Adults, 5-4-30 Moriyama, Moriyama, Shiga, Japan. Electronic address: kasahara520325@gmail.com.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kasahara
authors.affiliation: Department of Orthopaedics, Shiga Medical Center for Adults, 5-4-30 Moriyama, Moriyama, Shiga, Japan. Electronic address: nra09812@nifty.com.
authors.forename: Masashi
authors.initials: M
authors.lastname: Kanamura
authors.affiliation: Department of Orthopaedics, Shiga Medical Center for Adults, 5-4-30 Moriyama, Moriyama, Shiga, Japan. Electronic address: kawanabe@mdc.med.shiga-pref.jp.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Kawanabe
keywords: Infected periprosthetic femoral fracture; Long stem; THA-like spacer; Total hip arthroplasty