Antibiotic spacer (knee)

Case contributed by Ashesh Ishwarlal Ranchod
Diagnosis certain

Presentation

Prior total arthroplasty of the right knee. Poor diabetic compliance with the onset of chronic septic arthritis.

Patient Data

Age: 60 years
Gender: Male
x-ray

There is a temporary right knee antibiotic spacer. There is a pencil drain in situ with normal post-operative soft tissue changes and overlying surgical staples. There is chronic osteomyelitis/septic arthritis with dense/sclerotic bone and sequestrum. Involucrum formation is suspected and could not be excluded on plain film.

Case Discussion

This is a case of a temporary right knee cement spacer impregnated with gentamicin in a patient with chronic septic arthritis post arthroplasty. There were ongoing non-resolving intra and peri-articular septic collections with the formation of sequestrum and draining cloaca.

The patient is a non-compliant diabetic with poor glucose control and consequently developed a septic arthroplasty post-surgery.

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