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(A) Anteroposterior and (B) Lateral x-ray of the right knee. This X-ray was taken post-operatively after external fixation was applied.
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Imaging results were: Chest x-ray was normal; Right knee x-ray (Figure 2) locally aggressive geographic lytic lesion eccentrically located in the distal femur.
Right knee MRI. (A and B) are T1 and T2 weighted sagittal images, respectively. (C and D) are T1 and T2 weighted coronal images, respectively.
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Formed bio-membrane after cement removal.
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Cement was embedded in a formed biomembrane (Figure 4).
Intramedullary nail and non-vascularized fibular graft in place.
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A proximal (2) and distal (2) interlocking screw was inserted with the guide of an image intensifier (Figure 5). The graft was then placed in the gap from the distal-most resected part of the femur to the tibia (Figure 5).
AP and Lateral X-ray of the femur (A and B, respectively). AP and Lateral X-ray of the tibia including knee joint (C and D, respectively).
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X-ray showed healing of the graft to the recipient site with callus formation (Figure 6).
Patient weight bearing with crutches at 1 year follow up.
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The subsequent follow-up was 1 year after surgery (Figure 7).
Full-length lower extremity radiograph at two years follow up (A) and lateral radiograph (B) showing healing at the proximal graft site at two years follow up.
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There was adequate healing and no recurrence was noted at the two-year follow-up (Figure 8).