• Puwadon Veerapan Department of Orthopedics, Phramongkutklao Hospital
  • Sittichoke Watcharamasbonkkot Department of Orthopedics, Phramongkutklao Hospital



Endoprosthesis reconstruction, Periprosthetic joint infection


Bone and connective tissue cancer treatment has been improved to achieve a significant survival rate. Limb salvage surgery, an efficient surgical technique, has been established to preserve limbs. Endoprosthesis reconstruction constitutes an essential part of the treatment method, and the attending medical team requires knowledge to reduce the side effects of this operation. The consequential infection is a common complication, often leading to worse use of the limbs when finishing the treatment. This report describes a patient presenting an infection in a prosthesis after endoprosthesis reconstruction using a limb salvage surgery technique. Due to the comprehensive resection surgery, the typical structure has been significantly damaged, which could lead to a high risk of neurovascular structure damage during adequate debridement and lead to the need for amputation. Thus, the decision to treat an infection resulted in patients undergoing multiple surgeries and reducing their functional outcomes until crucial. These patients should be carefully monitored to prevent infection and obtain a good quality of life in the long term.


Metrics Loading ...


Darling J.Adifferent view of sarcoma statistics. ESUN 2007; 4: 1-7.

Meyers PA, Gorlick R. Osteosarcoma. Pediatr Clin N Am 1997; 44: 973-89. DOI:

Rougraff BT, Simon MA, Kneisl JS, Greenberg DB, Mankin HJ. Limp salvage compared with amputation for osteosarcoma of the distal end of the femur. J Bone Jt Surg 1994; 76: 649-56. DOI:

Wilson RJ, Sulieman LM, VanHouten J, Halpern JL, Schwartz HS, Devin CJ, et al. Cost-utility of osteoarticular allograft versus endoprosthetic reconstruction for primary bone sarcoma of the knee: A Markov analysis. J Surg Oncol 2017; 115: 257-65. DOI:

Haijie L, Dasen L, Tao J, Yi Y, Xiaodong T, Wei G. Implant survival and complication profiles of endoprostheses for treating tumor around the knee in adults: A systematic review of the literature over the past 30 years. J. Arth 2017; 33: 1275-87. DOI:

Osmon DR, Berbari EF, Berendt AR, Lew D, Zimmerli W, Steckelberg JM, et al. Diagnosis and management of prosthetic joint infection: Clinical practice guidelines by the infectious disease society of America. Clin Infect Dis 2013; 56: e1-e25 DOI:

Berger C, Larsson S, Bergh P, Brisby H, Wennergren D. The risk for complications and reoperations with the use of mega prostheses in bone reconstructions. J Orthop Surg Res 2021; 16: 598-608. DOI:

Zan P, Wang H, Cai Z, Shen J, Sun W. Revision surgeries for tumor endoprostheses around the knee joint: a mid-long-term follow-up of 20 cases. World J Surg Oncol 2022; 20: 76-84. DOI:

Zajonz D, Zieme A, Prietzel T, Moche M, Tiepoldt S, Roth A, et al. Periprosthetic joint infections in modular endoprostheses of the lower extremities: a retrospective observational study in 101 patients. Patient Saf Surg 2016; 10: 6-15. DOI:

Klenerman L. The management of the infected endoprosthesis. Bone Joint J Surg Br 1984; 66: 645-51. DOI:

Tsukayama DT, Goldberg VM, Kyle R. Diagnosis and management of infection after total knee arthroplasty. J Bone Joint Surg Am. 2003; 85: 75–80. DOI:

Mandell GL, Vest TK. Killing of intraleukocytie staphylococcus aureus by rifampin: in-vitro and in-vivo studies. J Infect Dis 1972; 125: 486-90. DOI:

Zimmerli W, Sendi P. Role of rifampin against staphylococcal biofilm infections in vitro, in animal models, and in orthopedic-devicerelated infections. Antimicrobe Agents Chemother 2019; 63: e01746-18. DOI:

Runyon BA, Umland ET, Merlin T. Inoculation of blood culture bottles with ascitic fluid. Improved detection of spontaneous bacterial peritonitis. Arch Intern Med 1987; 147: 73–5. DOI:

Menzies SM, Rahman NM, Wrightson JM, Davies HE, Shorten R, Gillespie SH, et al. Blood culture bottle culture of pleural fluid in pleural infection. Thorax 2011; 66: 658–62. DOI:




How to Cite

Veerapan P, Watcharamasbonkkot S. PERIPROSTHETIC JOINT INFECTION AFTER WIDE RESECTION BONE TUMOR AND ENDOPROSTHETIC RECONSTRUCTION IN A PATIENT WITH OSTEOSARCOMA: A CASE REPORT. J Southeast Asian Med Res [Internet]. 2023 Aug. 30 [cited 2023 Dec. 8];7:e0154. Available from:



Case Reports

Most read articles by the same author(s)

Similar Articles

You may also start an advanced similarity search for this article.