Cement-a-TAN Temporary Proximal Femoral Replacement for Staged Joint Replacement - A Case Report

Area of Science:

• Orthopedic surgery
• Infectious disease management
• Biomaterials engineering

Background:

• Infected non-unions of proximal femoral fractures present significant treatment challenges.
• Staged revision arthroplasty is often necessary after failed debridement and fixation.
• Significant bone loss in the proximal femur limits available temporary spacing options.

Observation:

• A case of bisphosphonate-induced subtrochanteric fracture with infected non-union is presented.
• Despite multiple interventions, active infection persisted.
• A custom antibiotic-eluting articulating temporary spacer, Cement-a-TAN, was fabricated using a cephalocondylar nail scaffold.

Findings:

• The Cement-a-TAN spacer successfully managed the infected non-union and bone loss.
• It maintained leg length, offset, and periarticular soft-tissue tension.
• Definitive proximal femoral arthroplasty was successfully performed after infection resolution.

Implications:

• Cement-a-TAN offers a viable solution for complex proximal femur reconstructions.
• This technique preserves joint function and stability during staged procedures.
• It addresses limitations in temporary spacing for cases with substantial bone defects.