The Journal of Bone and Joint Surgery (American). 2005;87:410-413.
doi:10.2106/JBJS.D.01948
© 2005 The Journal of Bone and Joint Surgery, Inc.
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 Trauma Test 7: Spring 2005
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Creation of an Above-the-Knee Amputation Stump After Hip Disarticulation for Severe Periprosthetic Infection and Fracture

A Report of Two Cases

Friedrich Bottner, MD1, Christian Götze, MD1, Armin Koller, MD2, Jörn Steinbeck, MD1, Winfried Winkelmann, MD1 and Georg Gosheger, MD1

1 Department of Orthopaedics, University Hospital of Muenster, A. Schweitzer Strasse 33, 48129 Muenster, Germany. E-mail address for F. Bottner: drboettner@email.de
2 Department of Technical Orthopaedics, University of Muenster, Robert-Koch-Strasse 30, 48149 Muenster, Germany

Investigation performed at the Department of Orthopaedics, University Hospital of Muenster, Muenster, Germany

The first 150 words of the full text of this article appear below.


   Introduction
 
Recurrent infection at the site of a total joint replacement secondary to a highly resistant organism in combination with a periprosthetic fracture presents a treatment challenge. To salvage this situation, a hip disarticulation or a type-B-IIIb rotationplasty, as described by Winkelmann, are the only viable surgical techniques reported in the literature of which we are aware1,2. The purpose of our report is to present an alternative surgical technique for creating an above-the-knee stump with use of a modular proximal femoral replacement with a bipolar head after hip disarticulation. The procedure consists of two stages.


   Stage One: Débridement and Implantation of a Cement Spacer
 
Following implant removal and débridement, an antibiotic-impregnated polymethylmethacrylate spacer is implanted. After the proximal part of the femur is removed, the greater trochanter is fixed to the spacer to prevent shortening of the gluteal muscles. During this first stage, either an immediate hip disarticulation with reconstruction of an above-the-knee stump is performed (Case 1) . . . [Full Text of this Article]


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