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Case Report: CERAMENT™ V in a two-stage infected knee revision

The 25year old female patient had an osteosarcoma in the proximal tibia, a course of chemotherapy and implantation of a hinged knee prosthesis. This became infected, and a two-stage arthrodesis was carried out. Find out more how four months later an X-ray shows bone remodeling in all areas where CERAMENT™ V has been injected

Bonesupport shares findings and experiences in a very detailed Case Report.

Patient

25 Year old female

Diagnosis

The patient had an osteosarcoma in the proximal tibia (Fig. 1), a course of chemotherapy (Fig. 2) and implantation of a hinged knee prosthesis (Fig. 3). This became infected, and a two-stage arthrodesis was carried out.

Treatment

  • In the first stage, the knee implant was removed, and a resection and thorough débridement of all infected and dead tissue was carried out.
  • The medullary canals were brushed and flushed with saline, and a 30-35 cm long metal rod was inserted from the femoral medullary canal into the tibial medullary canal.
  • CERAMENT™ V was injected around the rod and into any cavities in both the femur and tibia, to provide a high dose of local antibiotic and improve bone stock for the second stage procedure.
  • To preserve leg length and for load-bearing, PMMA was shaped and placed around the metal rod and between the femoral and tibial bone ends.
  • Four months later the second stage was carried out and the metal rod was replaced with an uncemented arthrodesis nail.

Outcome

  • Immediately post-operatively CERAMENT™ V is clearly visible at the distal femur and proximal tibia.
  • An x-ray following the second stage procedure four months later shows bone remodeling in all areas where CERAMENT™ V has been injected.

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Case Report: CERAMENT V in a two-stage infected knee revision (pdf, 1 MB)

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