# Short-interval total femur replacement for infected distal femoral reconstruction

**Authors:** Danil Chernov, Nicholas Frappa, Morgan Dillon, Alexander Kovacs, Matthew Alben, Ryan Riley, Joseph B Kuechle

PMC · DOI: 10.1093/jscr/rjag122 · Journal of Surgical Case Reports · 2026-03-07

## TL;DR

A new two-stage surgery helped control infection and preserve limb function in a patient with severe bone loss after femur replacement.

## Contribution

A novel short-interval two-stage revision technique for complex periprosthetic infections with extensive bone loss.

## Key findings

- A custom antibiotic-loaded femur spacer was placed followed by definitive replacement one week later.
- Early follow-up showed successful infection control and functional limb preservation.
- The approach offers a potential solution for limb salvage in complex cases.

## Abstract

We present the case of a 61-year-old woman, initially treated for distal femoral osteosarcoma with a distal femur replacement (DFR) and multiple prior revisions, who presented with chronic infection of the DFR and catastrophic proximal femoral bone loss, representing a formidable reconstructive challenge. She underwent a novel short-interval two-stage revision consisting of proximal femur resection and placement of a custom antibiotic-loaded total femur spacer, followed 1 week later by definitive total femur replacement. Early follow-up demonstrated infection control and preservation of a functional limb. This case highlights the potential of an abbreviated two-stage approach for limb salvage in complex periprosthetic infections with extensive bone loss.

## Linked entities

- **Diseases:** osteosarcoma (MONDO:0002623)

## Full-text entities

- **Diseases:** extensor mechanism loss (MESH:D041781), dislocation (MESH:D004204), infected (MESH:D007239), oncologic (MESH:D000072716), bone loss (MESH:D001847), PJI (MESH:D057068), tibial shaft fracture (MESH:D013978), contracture (MESH:D003286), osteosarcoma (MESH:D012516), reinfection (MESH:D000084063), fracture (MESH:D050723), loosening (MESH:D011475)
- **Chemicals:** DFR (-), cefazolin (MESH:D002437)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

4 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12966780/full.md

## References

11 references — full list in the complete paper: https://tomesphere.com/paper/PMC12966780/full.md

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Source: https://tomesphere.com/paper/PMC12966780