CASE REPORT
A Novel Antibiotic Spacer for Significant Proximal Femoral Loss - Surgical Technique
David Shields, Roderick Kong*, Sanjay Gupta, Ashish Mahendra
Article Information
Identifiers and Pagination:
Year: 2017Volume: 11
Issue: Suppl-3, M6
First Page: 508
Last Page: 516
Publisher ID: TOORTHJ-11-508
DOI: 10.2174/1874325001711010508
Article History:
Received Date: 12/11/2016Revision Received Date: 21/02/2017
Acceptance Date: 23/02/2017
Electronic publication date: 31/05/2017
Collection year: 2017

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background:
Infections of proximal femora with prosthetic implants in situ have long been a major concern in orthopedic surgery. The gold standard in the management of infected proximal femurs in the presence of prosthetic implants has traditionally been a two-stage revision. However, this is challenging in the setting of extensive bone loss.
Methods:
A 3 case series of such infections leading to extensive loss of the proximal femur is presented. We specifically describe our technique of debriding the infected segments as well as utilization of a trochanteric slide osteotomy to resect the femur.We also demonstrate preparation of the “pseudoacetabulum” and femoral component with an antibiotic spacer.
Conclusion:
The high cost of such a procedure is offset by reduction in time spent in hospital. The spacer also helps to allow mobilization by partial weight bearing on a stable femoral component and provide pain control which improves quality of life as compared to prolonged intravenous antimicrobial therapy.