Periprosthetic knee infection (PKI) remains one of the most challenging complications after total knee replacement, especially if caused by multidrug-resistant (MDR) or extensively drug-resistant (XDR) organisms. Multiple treatment options are available, such as long-term antibiotic suppression, surgical debridement with retention of the prosthesis, definitive resection arthroplasty, arthrodesis, one-stage or two-stage revision procedures, amputation.
We present a rare case of a PKI caused by a XDR Klebsiella pneumoniae in a young patient who underwent a prosthetic reconstruction due to an osteosarcoma of the tibia. In this patient, the PKI has been treated using intravenous administration of Amikacin and an Amikacin-impregnated PMMA custom-made spacer.
To our knowledge, only two cases that successfully used hand-mixed antibiotic-loaded spacer based on antibiotic sensitivity for the treatment of PKI caused by MDR and XDR microorganisms have been reported in the literature.
To cite this article
G. Noia, M.C. Meluzio, G. Sircana, G. Maccauro, M. Fantoni, A. Ziranu
The use of custom-made antibiotic-loaded spacer in periprosthetic knee infection caused by XDR organism: case report and review of literature
Eur Rev Med Pharmacol Sci
Vol. 23 - N. 2 Suppl