PMC3927377_01
AP and lateral X-rays showing type IIB periprosthetic
tibial fracture.
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PMC3927377_01_TOORTHJ-8-24_F1.jpg
F1
An 85-year-old woman with hypertension, dementia and dependent for normal life activities presented after an accidental fall with a left periprosthetic tibial fracture around total knee arthroplasty (Alpina , Biomet-France) implanted 9 years ago (Fig. 1).
AP and lateral post-surgical X-rays after the replacement
of tibial component.
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F2
To treat this lesion, areplacement of the tibial component by one with a long stem was performed (Fig. 2).
AP and lateral X-rays after implantation of bone-cement
spacer coated with clindamycin and gentamicin and a handmade
stem with a metal core.
TOORTHJ-8-24_F3.jpg
PMC3927377_01_TOORTHJ-8-24_F3.jpg
F3
Despite this surgical approach and parenteral antibiotherapy with vancomycin and imipenem, the clinical evolution was non-satisfactory, so after three days, all components were removed and a bone-cement spacer coated with clindamycin and gentamicin and a handmade stem with a metal core was implanted (Fig. 3).
AP and lateral X-rays at 24 months follow-up.
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F4
There were no radiological (Fig. 4), clinical (Fig. 5), or blood analysis signs of infection.