PMC8406042_01
(a) Preoperative anteroposterior radiograph. Osteolytic changes are seen around the implant. (b) Postoperative radiograph of the transfemoral amputation site. The functional stump length (from the inferior edge of the ischium to the bone stump) was 6 cm. (c) Magnetic resonance imaging obtained 52 days after the amputation surgery revealed subcutaneous abscess and osteomyelitis of the residual femur.
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Radiography showed osteolytic changes around the implant (Fig. 1a). As a result, the functional stump length (from the inferior edge of the lesser trochanter to the bone stump) was 6 cm (Fig. 1b). Magnetic resonance imaging revealed subcutaneous abscesses and osteomyelitis of the residual femur (Fig. 1c).
(a) Antibiotic-loaded cement implantation into the medullary cavity of the residual femur to control infection and preserve bone length. (b) Findings at 18 months after the last surgery. Functional gait was regained with the use of a femoral prosthesis.
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Instead of additional bone excision, 40 g of bone cement (Surgical Simplex, Stryker, Kalamazoo, MI, USA) containing 2 g of vancomycin (vancomycin hydrochloride for intravenous infusion 0.5 g [MEEK], Meiji Seika Pharma Co., Ltd., Tokyo, Japan) was implanted into the medullary cavity of the residual femur to control infection and preserve bone length (Fig. 2a). Other parts of the prescribed prosthesis included a 4-bar hydraulic microprocessor-controlled stance, a swing phase-controlled knee, and a hydraulically controlled foot for the prosthetic limb (Fig. 2b).