Biau et al described a case of distal femur bone loss stabilised with intramedullary nail and antibiotic spacer
followed by secondary grafting and eventual healing.
The type of antibiotic spacer
that should be used has also been a controversial topic.
Our case reports the third highest serum tobramycin and second highest serum creatinine for patients experiencing ARF due to an antibiotic spacer
in two-stage revision TKA.
 proposed large debridement and implant removal but with no antibiotic spacer
. Once the blood inflammatory parameters were normalized, a total knee replacement was implanted.
Orthopedic Surgery was consulted and recommended keeping the antibiotic spacer
to optimize future joint mobility.
Mader, "An articulated antibiotic spacer
used for infected total knee arthroplasty: A comparative in vitro elution study of Simplex[R] and Palacos[R] bone cements," Journal of Orthopaedic Research, vol.
The efficacy was additionally demonstrated with successful implementation in cases of polymicrobial PJIs primarily treated with other antibiotic spacer
After institutional review board approval, we queried the surgical database of our academic medical center for patients who underwent a stage-one explantation and antibiotic spacer
placement for the treatment of PJI from 1998 to 2010 by a single surgeon.
 showed an average incidence of acute kidney injury of 4.8% using antibiotic spacer
. Berend at al.
During the perioperative period with an antibiotic spacer
, ESR and CRP values often times do not return to absolute normal values; on a case by case basis, aspiration of the affected joint after the same antibiotic holiday period will assist the surgeon in completing their assessment of infection eradication.
She then developed a MSSA infection, requiring removal of hardware and placement of an antibiotic spacer
. She completed a course of antibiotics and subsequently underwent total knee arthroplasty, which was complicated by MRSA infection with development of a sinus tract communicating with the distal femur.
Once the canal has been adequately debrided, a long stem implant or antibiotic spacer