High-energy open fractures are frequently complicated by osteomyelitis and femoral nonunion. Treatment of these conditions poses a significant challenge for surgeons and often results in limb amputation. A case of an infected nonunion of open distal femoral fracture, complicated by osteomyelitis and septic arthritis of the knee caused by a multidrug-resistant strain of Acinetobacter baumannii and methicillin-resistant Staphylococcus epidermidis with the initial Oxford Knee Score (OKS) of 7/48 is presented. The report demonstrates the use of a two-stage arthroplasty technique with an articulating spacer during the first stage for a metaphyseal-diaphyseal femoral defect of 8 cm, preserving the weight-bearing capacity and function of the knee joint (OKS of 18); whereas at the second stage, the segmental defect was repaired with an allograft and a tantalum cone (OKS of 32). This case serves as a valuable reference for medical professionals dealing with chronic osteomyelitis involving the knee joint and arthroplasty. Further research on this technique is necessary to improve clinical outcomes.
Afanasyev et al. (Fri,) studied this question.