An Unusual Complication after Infected Total Knee Arthroplasty

One-stage or two-stage revision total knee arthroplasty (TKA) in periprosthetic joint infections has been at the center of scientific debate for many years. As regards two-stage revision TKA, cement spacers have a good infection control rate with successful results reportable up to 96%, though some studies describe related spacer complications such as stiffness and loss of bone stock. We report a case of a fracture close to the antibiotic-loaded cement spacer in a 74-year-old female patient. Due to the blood tests and high risk of infection, we performed a hybrid external fixator. Six months after the surgery, X-rays did not show signs of fracture consolidation and nonunion was considered as an impending complication; therefore, the decision was made to perform tumor-like total knee arthroplasty. The postoperative evolution was satisfactory and return to daily activity without pain. At the 5-year follow-up, the patient showed a good score of 36-Item Short Form Health Survey and a range of motion from 0 to 90° without pain. The X-rays did not show signs of mobilization, dislocation, recurrence of infection, or other complications.