The First Stage of Knee Revision Arthroplasty in Periprosthetic Infection with Replacement of a Large Defect Double Cementing Method: A Case Report

Abstract

Aim

Large bone defects in patients with chronic deep periprosthetic knee infection is a major problem. It is widely accepted that bone defects filling with polymethylmethacrylate (PMMA) cement could be used only in selected cases of small bone defects (up to 5 mm) and less than 50% of articular surface due to multiple reasons: risk of thermal bone damage, inadequate cement pressurization and bone cement shrinkage, etc. Staged cementing for preventing bone heating and over negative effects of cementing on a thick layer of bone cement has limited support in the literature.

Case Presentation

We present the case of 4.5 years follow up after temporary-permanent spacer implantation in a 63-year-old male with chronic deep knee PJI and tibial AORI type 3 bone defect reconstructed via double cementing method.

Results

Method of double (staged) cementing used for reconstruction of epiphyseal tibial bone defect in a patient with fistula form of knee PJI shows excellent clinical results at 4.5 years follow up.

Keywords:

• bone cement
• knee joint
• periprosthetic joint infection
• tibial defect

Data Sharing Statement

All data generated or analyzed during this study are included in this published article.

Ethics Approval and Consent to Participate

Written informed consent was obtained from this patient. The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of the National Scientific Center of Traumatology and Orthopedics Named after Academician N.D. Batpenov (protocol code #4 and date of approval October 19, 2021).

Consent for Publication

Written informed consent has been obtained from the patient to publish this paper and all of accompanying images.

Disclosure

The authors declare that they have no conflicts of interest.

Additional information

Funding

This study was conducted within the framework of the scientific and technical program of program-targeted financing by the Ministry of Health of the Republic of Kazakhstan (No. BR11065157). The funders had no role in the study design, collection, analyses, interpretation of data, writing of the manuscript, or decision to publish the results.