Baylor College of Medicine, Houston, TX, United States.
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.
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