case_images: PMC3927377_01
case_images: AP and lateral X-rays showing type IIB periprosthetic
  tibial fracture.
case_images: TOORTHJ-8-24_F1.jpg
case_images: PMC3927377_01_TOORTHJ-8-24_F1.jpg
case_images: F1
case_images: An 85-year-old woman with hypertension, dementia and dependent for normal life activities presented after an accidental fall with a left periprosthetic tibial fracture around total knee arthroplasty (Alpina , Biomet-France) implanted 9 years ago (Fig. 1).
case_images: AP and lateral post-surgical X-rays after the replacement
  of tibial component.
case_images: TOORTHJ-8-24_F2.jpg
case_images: PMC3927377_01_TOORTHJ-8-24_F2.jpg
case_images: F2
case_images: To treat this lesion, areplacement of the tibial component by one with a long stem was performed (Fig. 2).
case_images: AP and lateral X-rays after implantation of bone-cement
  spacer coated with clindamycin and gentamicin and a handmade
  stem with a metal core.
case_images: TOORTHJ-8-24_F3.jpg
case_images: PMC3927377_01_TOORTHJ-8-24_F3.jpg
case_images: F3
case_images: Despite this surgical approach and parenteral antibiotherapy with vancomycin and imipenem, the clinical evolution was non-satisfactory, so after three days, all components were removed and a bone-cement spacer coated with clindamycin and gentamicin and a handmade stem with a metal core was implanted (Fig. 3).
case_images: AP and lateral X-rays at 24 months follow-up.
case_images: TOORTHJ-8-24_F4.jpg
case_images: PMC3927377_01_TOORTHJ-8-24_F4.jpg
case_images: F4
case_images: There were no radiological (Fig. 4), clinical (Fig. 5), or blood analysis signs of infection.