case_images: PMC5481614_01
case_images: Pelvic x-ray showing the retained femoral stem prior to the second revision.
case_images: TOORTHJ-11-508_F4.jpg
case_images: PMC5481614_01_TOORTHJ-11-508_F4.jpg
case_images: F4
case_images: Intraoperatively, a periprosthetic fracture occurred while attempting to remove the well-fixed stem (Fig. 4).
case_images: Postoperative X-rays showing the temporary antibiotic spacer construct. Note the antibiotic cement does not surround the nail within the bone, as opposed to a pre-constructed antibiotic nail.
case_images: TOORTHJ-11-508_F5.jpg
case_images: PMC5481614_01_TOORTHJ-11-508_F5.jpg
case_images: F5
case_images: The patient had debridement and excision of the proximal femur as per this described technique (Fig. 5).
case_images: CRP trend in the pre and post operative period.
case_images: TOORTHJ-11-508_F6.jpg
case_images: PMC5481614_01_TOORTHJ-11-508_F6.jpg
case_images: F6
case_images: The inflammatory markers subsequently normalized (Fig. 6).
case_images: Definitive reconstruction with proximal femoral replacement and cone pelvis reconstruction.
case_images: TOORTHJ-11-508_F7.jpg
case_images: PMC5481614_01_TOORTHJ-11-508_F7.jpg
case_images: F7
case_images: After a 3 month period, 6 weeks of which outpatient intravenous antibiotics were given, the definitive reconstruction with a cone hemipelvis and proximal femoral replacement was performed (Fig. 7).
case_images: PMC5481614_02
case_images: X-ray and MRI showing pathological fracture with involvement of proximal femoral diaphysis.
case_images: TOORTHJ-11-508_F8.jpg
case_images: PMC5481614_02_TOORTHJ-11-508_F8.jpg
case_images: F8
case_images: A 71-year old female presented with a pathologic intracapsular fracture of the left proximal femur (Fig. 8) which was diagnosed as a primary diffuse large B-cell lymphoma amenable to curative therapy.
case_images: Proximal femoral replacement as management of the pathological fracture.
case_images: TOORTHJ-11-508_F9.jpg
case_images: PMC5481614_02_TOORTHJ-11-508_F9.jpg
case_images: F9
case_images: A proximal femoral resection and replacement with a bipolar head was performed (Fig. 9).
case_images: Postoperative x-ray following 1st stage revision.
case_images: TOORTHJ-11-508_F10.jpg
case_images: PMC5481614_02_TOORTHJ-11-508_F10.jpg
case_images: F10
case_images: Despite an irrigation and debridement, her symptoms persisted and a two-stage revision was performed using the described technique (Fig. 10).
case_images: X-ray 3 years following 2nd stage revision with no evidence of loosening and signs of bone integration onto the prosthesis.
case_images: TOORTHJ-11-508_F11.jpg
case_images: PMC5481614_02_TOORTHJ-11-508_F11.jpg
case_images: F11
case_images: A silver-coated proximal femoral replacement was implanted 3 months later after normalization of inflammatory markers and withdrawal of antibiotics (Fig. 11).
case_images: PMC5481614_03
case_images: Preoperative MRI and postoperative x-ray of the pleomorphic sarcoma reconstructed with a coned pelvis.
case_images: TOORTHJ-11-508_F12.jpg
case_images: PMC5481614_03_TOORTHJ-11-508_F12.jpg
case_images: F12
case_images: This was curatively excised with extra-articular resection and reconstructed with a coned pelvis with a subsequent unremarkable recovery (Fig. 12).
case_images: Post operative x-ray of femoral spacer. Note long segment of nail buried into void from previous femoral component stem and preservation of coned pelvis.
case_images: TOORTHJ-11-508_F13.jpg
case_images: PMC5481614_03_TOORTHJ-11-508_F13.jpg
case_images: F13
case_images: The patient had the first stage of his revision completed (Fig. 13).