JBJS | Creation of an Above-the-Knee Amputation Stump After Hip Disarticulation for Severe Periprosthetic Infection and Fracture: A Report of Two Cases

The Journal of Bone & Joint Surgery, Volume 87, Issue 2

Case Reports | February 01, 2005

Creation of an Above-the-Knee Amputation Stump After Hip Disarticulation for Severe Periprosthetic Infection and Fracture: A Report of Two Cases

Friedrich Bottner, MD¹; Christian Götze, MD¹; Armin Koller, MD²; Jörn Steinbeck, MD¹; Winfried Winkelmann, MD¹; Georg Gosheger, MD¹

¹ Department of Orthopaedics, University Hospital of Muenster, A. Schweitzer Strasse 33, 48129 Muenster, Germany. E-mail address for F. Bottner: drboettner@email.de
² Department of Technical Orthopaedics, University of Muenster, Robert-Koch-Strasse 30, 48149 Muenster, Germany

The Journal of Bone & Joint Surgery. 2005; 87:410-413 doi:10.2106/JBJS.D.01948

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Extract

Recurrent infection at the site of a total joint replacement secondary to a highly resistant organism in combination with a periprosthetic fracture presents a treatment challenge. To salvage this situation, a hip disarticulation or a type-B-IIIb rotationplasty, as described by Winkelmann, are the only viable surgical techniques reported in the literature of which we are aware1,2. The purpose of our report is to present an alternative surgical technique for creating an above-the-knee stump with use of a modular proximal femoral replacement with a bipolar head after hip disarticulation. The procedure consists of two stages.

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Topics

fracture ; amputation stumps ; infection ; disarticulation of hip ; amputation above-knee ; femur ; spacer, cement

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These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.

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