Osteomyelitis Treatment - Southern California, REOrthopaedics Inc. Featured case 1

Treatment for Infected Non-union and Osteomyelitis in Southern California - Proximal Tibia: Total Knee Arthroplasty - Free-fFap - Vascularized Latisimus Dorsi Myoplasty - Extensor Mechanism Repair

D.G. and Y.Y. (Featured Cases #1 and #2, respectively) meeting face-to-face, for the first time in the recovery room at San Diego's Sharp Memorial Hospital after first connecting on-line when looking for (and finding) help regarding their musculoskeletal infections of the tibia at www.osteomyelitis.com .     Case #1: Had Suzanne not gone on-line to find your Web page (www.osteomyelitis.com), reached out to you for a consult, found Yumi in New Mexico (Case #2, to follow) and get her on a path your doorstep , I think there would likely be two people found hopping around with a missing limb right now ------------ both Yumi and I had an infected non-union ( type IV osteomyelitis) of the tibia.  Dr. Cierny, from the very beginning, your confidence in our shared ability to successfully treat this injury and save my limb motivated me to endure, restored by faith in medicine and renewed b my commitment to surgical solution.  Sincerely, Dave Giaimo, Atlanta GA

D.G. in Atlanta – (A) Old wound at top of the leg, just below knee, showing skin loss and previous drainage site (blk. arrow) following failed treatment of an open, intra-articular fracture of the proximal tibia initially treated with screws, a plate and bone grafts. (B) An x-ray taken at the time of Dave’s first consultation in San Diego disclosing the infected non-union(Stage IVA osteomyelitis, tibia and knee joint),  joint incongruity and limb deformity (dotted arrow).  C) X-ray of his initial stabilization following debridement: a temporary knee fusion performed with a large antibiotic-spacer (blk. Arrow) and an antibiotic-coated fusion rod (NEFF nail) to allow full weight bearing and maintain limb length while his reconstructed soft tissues healed.  D) The injured skin and soft tissue at the front of the knee were replaced with a free-tissue transfer (wt. arrow: latisimus dorsi muscle flap) using a microvascular  anastomosis.    D.G. in Atlanta - E) Clinical photograph of the healed flap at the time of the second stage of his reconstruction, F) a custom total knee arthroplasty (TKA) where in the proximal 4 inches of Dave's tibia were replaced with a metal tibial segment and the knee joint with a rotating, metal-on-polyethylene bearing.