Creating a dual articulating antibiotic spacer for management of an infected total femur prosthesis hemiarthroplasty

The gold standard for management of chronic periprosthetic joint infections is a 2-stage revision arthroplasty with the first stage being explantation, debridement, and placement of a spacer. While there are implants designed to manage periprosthetic infections in hip and knee arthroplasty, there are not any commercially available implants designed to specifically manage an infected total femur megaprosthesis. This creates a unique surgical challenge and requires custom construction of a spacer to be performed by the surgeon intraoperatively. Here, we present our surgical technique for manufacturing a dual articulating total femur spacer. This technique facilitates range of motion at both the hip and knee joints, provides stability for axial loading in the extremity, and preserves the acetabulum while the patient undergoes antibiotic therapy to eradicate the infection.