Knee Fusion with Gradual Shortening and Staged Insertion of Antibiotic Coated Intramedullary Nail for Failed Infected Total Knee Arthroplasty

This case is about a female patient with multiple failed infected total knee arthroplasties (TKA) Failed infected total knee arthroplasties (TKA)associated with persistent active infection and incapacitation with inability to bear weight on the affected knee. Eradication of infection was achieved by removal of infected implants and wide resection of all infected bone. The resultant bone defectBone defect across the joint (8 cm) was spanned with a Taylor Spatial Frame (TSF) Taylor Spatial Frame (TSF) that was used to gradually shorten the femoral and tibial bone ends across this defect. Once the soft tissue gap was reduced and bony apposition was attained, knee fusion via an antibiotic-coated intramedullary nail (IMN) Antibiotic coated intramedullary nail (IMN)was performed. This resulted in a solid knee fusionKnee fusion with complete eradication of infection. Residual leg length discrepancy was managed by a shoe lift; limb lengthening was not performed for this elderly patient. At 1 year postoperatively, the patient was completely infection-free, pain-free, and ambulating with a very good functional outcome.