Surgical Discussion

Patient positioning:  The patient was positioned supine on the operating table, with the affected limb prepared for extensive exposure from the distal femur to the proximal tibia.

Anatomical surgical approach:  A longitudinal midline incision was made over the knee joint, extending from the distal femur to the proximal tibia. Subperiosteal dissection was performed to expose the distal femur and proximal tibia. Radical debridement of infected and necrotic bone was carried out, followed by stabilization with carbon rods and bone cement to achieve mechanical arthrodesis.

The surgeon noted significant bone loss and extensive osteomyelitic changes necessitating aggressive debridement. Mechanical arthrodesis was achieved with carbon rods and bone cement, providing immediate stability. The plan included removal of the mechanical construct at 12 weeks, followed by consideration for endoprosthetic replacement.

Postoperative protocol:   Postoperative rehabilitation included early mobilization with walking and muscle strength training to maintain overall limb function and prepare for potential future reconstructive procedures.

Follow up:   Not specified.

Orthopaedic implants used:   Carbon rods, bone cement.