A minimally invasive technique to remove broken cemented stems and its reconstruction with cement-in-cement.

Introduction:: Historically the removal of fractured stems was associated with complex revision and loss of bone stock. This study describes a minimally invasive procedure for extraction of the distal part of a broken cemented stem that does not compromise the bone stock and results with the cement-in-cement reconstruction technique.

Materials And Method:: 7 patients with an average age of 74 years who underwent total hip replacement (THR) revision for fracture of femoral stems were included.

Periprosthetic fungal infection of a hip caused by .

An immunocompromised patient with a history of multiple hip implant revisions extended courses of empiric antibiotic treatment, and a retained metallic rod in the femoral medullary canal was transferred for diagnostic studies and treatment. A high suspicion of fungal infection and utilization of extended and specific fungal cultures were the diagnostic keys for infection with . The treatment consisted in a debridement surgery with the use of a functional spacer with cement supplemented with voriconazole and vancomycin plus a 6-month systemic treatment with voriconazole.