Creation of an Above-the-Knee Amputation Stump After Hip Disarticulation for Severe Periprosthetic Infection and Fracture

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Abstract
Following implant removal and débridement, an antibiotic-impregnated polymethylmethacrylate spacer is implanted. After the proximal part of the femur is removed, the greater trochanter is fixed to the spacer to prevent shortening of the gluteal muscles. During this first stage, either an immediate hip disarticulation with reconstruction of an above-the-knee stump is performed (Case 1) or the extremity is preserved (Case 2). The former should be considered for a patient with a severe periprosthetic fracture, severe vascular compromise distally, or inadequate soft-tissue coverage.

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