Short-interval total femur replacement for infected distal femoral reconstruction

We present the case of a 61-year-old woman, initially treated for distal femoral osteosarcoma with a distal femur replacement (DFR) and multiple prior revisions, who presented with chronic infection of the DFR and catastrophic proximal femoral bone loss, representing a formidable reconstructive challenge. She underwent a novel short-interval two-stage revision consisting of proximal femur resection and placement of a custom antibiotic-loaded total femur spacer, followed 1 week later by definitive total femur replacement. Early follow-up demonstrated infection control and preservation of a functional limb. This case highlights the potential of an abbreviated two-stage approach for limb salvage in complex periprosthetic infections with extensive bone loss.