Concomitant Cement Spacer and Peri-spacer Fractures Seven Years After First-stage Revision Knee Arthroplasty: A Case Report.

INTRODUCTION: Prosthetic joint infections (PJIs) remain an undesirable complication after total knee arthroplasties. Two-stage revision arthroplasty is the current standard of care for treating PJIs. However, the incidence of spacer retention for prolonged periods is increasing, with little known about its potential complications.

CASE REPORT: We present a case of a 64-year-old female of Southeast Asian descent who had a cement spacer maintained in-situ for 7 years due to poor patient compliance with subsequent follow-up.

CONCLUSION: While patients have satisfactory functional outcomes with the cement spacer, it is not meant for permanent weight bearing. Two-stage revision arthroplasties are only as effective as patients' compliance with subsequent follow-up and surgery. Clinicians must discourage patients from forgoing subsequent follow-up visits and surgery despite satisfactory function and quality of life with the cement spacer in situ to prevent complications related to prolonged retention of cement spacers.