Abstract
Two-stage exchange procedures appear to give the most consistent results in the management of the deep infection after the Total Knee Arthroplasty w x 1,3,5,7,8,10,11 . The use of an antibiotic impregnated polymethw x ylmethacrylate 4 spacer block in the interval after radical primary debridement, provides antibiotic delivery, preserves some movement and stability and perhaps greater patient comfort and mobility. We report a subluxed acrylic block used in the first stage causing significant compromise of a vascularised medial gastrocnemius flap used to repair a soft tissue defect after debridement. This case suggests that in an effort to prevent both migration and translation of an acrylic block, intra-operative fashioning of the spacer block should include intramedullary projection on both femoral and tibial sides.
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