BackgroundA two-stage revision remains as the "gold standard" treatment for chronically infected total knee arthroplasties.MethodsForty-five septic knee prostheses were revised with a minimum follow-up of 5 years. Static antibiotic-impregnated cement spacers were used in all cases. Intravenous antibiotics according to sensitivity test of the culture were applied during patients' hospital stay. Oral antibiotics were given for another 5 weeks. Second-stage surgery was undertaken after control of infection with normal erythrocyte sedimentation rate and C-reactive protein values. Extensile techniques were used if needed and metallic augments were employed for bone loss in 32 femoral and 29 tibial revisions.ResultsThe average interval between the first-stage resection and reimplantation was 4.4 months. Significant improvement was obtained with respect to visual analog scale pain and clinical and functional scores, and infection was eradicated in 95.6% of cases following a two-stage revision total knee arthroplasty. Radiographic evaluation showed suitable alignment without signs of mechanical loosening.ConclusionsThis technique is a reasonable procedure to eradicate chronic infection in knee arthroplasty and provides proper functional and clinical results. However, it sometimes requires extensile surgical approaches that could imply arduous surgeries. Metallic augments with cementless stems available in most of the knee revision systems are a suitable alternative to handle bone deficiencies, avoiding the use of bone allografts with its complications.

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Primary bone lymphangiomatosis is a disease of unknown etiology that can cause lytic lesions in long bones, the pelvis, the spinal column and the cranium. We are presenting the case of a woman with localized bone lymphangiomatosis in the left knee. The authors believe this is the first case in which percutaneous osteoplasty was used in long bones for the treatment of bone lesions resulting from this disease showing good clinical results.

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