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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2005 December;56(6):505-9
language: English, Italian
The treatment of a chronically infected knee with marked joint destruction in a young patient A two-stage approach to primary knee arthroplasty complicated by displaced supracondylar femoral fracture
Piscopo A., Zanchini F., Ruggiero C., Palmieri M.
Department of Orthopedics and Traumatology I Second University of Naples, Naples, Italy I Clinica Ortopedica e Traumatologica Facoltà di Medicina e Chirurgia, Seconda Università degli Studi di Napoli, Napoli
The more marked joint destruction in a chronically infected knee is, the more complex is the treatment. Our case involves a 38-year-old female patient who suffered from a chronically infected knee with marked joint destruction. She was treated surgically for an exposed fracture of the patella and, despite a number of medical and surgical treatments, joint destruction was almost total. A resection arthroplasty was carried out and an antibiotic cement spacer implanted. An AGC 2000 posterior stabilized-type arthroplasty was executed. Four months later, following a violent trauma, the patient was referred to our department complaining of violent pain, tumefaction, ecchymosis and total functional impotence of the femur-tibial joint. Radiographic examination pointed to a supracondylar femural fracture, Rorabeck type II. For this fracture she was surgically treated again with ORIF retrogradely nailed. After a 30 month follow-up, the joint condition in this patient, who in the past would have been destined to arthrodesis and amputation, showed an 85 Knee Society score, a 5°-110° range of motion (ROM) and no infection. The surgical technique used was that of Windsor and Insall, that is a two-stage implantation, and based on the experience of by former authors.