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Case Reports in Orthopedics
Volume 2017, Article ID 5141032, 6 pages
Case Report

Chronic Osteomyelitis of the Distal Femur Treated with Resection and Delayed Endoprosthetic Reconstruction: A Report of Three Cases

1Duke University Hospital, 1308 Mallory Lane, Durham, NC 27713, USA
2Duke University Hospital, 20 Duke Medicine Circle, Durham, NC 27710, USA
3Louisiana State University, 1542 Tulane Avenue, Box T6-7, New Orleans, LA 70112, USA

Correspondence should be addressed to Sean Ryan; ude.ekud@nayr.p.naes

Received 13 March 2017; Accepted 18 July 2017; Published 15 August 2017

Academic Editor: Elke R. Ahlmann

Copyright © 2017 Sean Ryan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Chronic osteomyelitis involving the distal femur often results in amputation or arthrodesis. This article presents three cases of chronic osteomyelitis treated with a staged approach culminating in endoprosthetic reconstruction. Stage one involved resection of infected bone and placement of an intramedullary nail spanning the bony defect between proximal femur and tibia, with antibiotic cement packed around the nail. Patients were then placed on long-term IV +/− oral antibiotics to clear the infection. A “cooldown” period was then used between stages where patients were off antibiotics and inflammatory markers were monitored for signs of remaining infection. Stage two then involved reconstruction of the distal femur and knee with an endoprosthesis. In the appropriate patient, this treatment strategy offers another option in this challenging population.