A Custom-Made Modular Mega-Spacer for the Treatment of Infection of a Total Femur Prosthesis: A New Surgical Technique

Background: Limb salvage surgery (LSS) with endoprosthetic replacement is a common method of reconstruction after bone tumor resection whenever there is no possibility for a biologic reconstruction. Post-operative infection is the most common reason for failure. Two-stage procedures require spacers to maintain the distance and to allow for mobilization. Because of the rarity and diversity of these cases there are no commercially available pre-fabricated solutions. Case Presentation: We present a simple novel method for a custom-made antibiotic-coated mega-spacer that we applied successfully in a patient with an infected mega-endoprosthesis after a wide resection of an osteosarcoma. Conclusion: Through its modularity the illustrated technique offers a good and inexpensive solution for individual adjustments for the preparation of interim prostheses especially for two-stage exchanges of mega-endoprosthesis. The optimum length can easily be adjusted. Furthermore, the explanation of the mega-spacer before replacement of a final prosthesis is simplified.