Femoral arthroplasty with bone cement as a salvage measure in open fracture with articular bone defect in young patients

Bone defects around the knee represent a major challenge, with multiple therapeutic alternatives such as mosaicplasty for managing minor defects or the use of patellar autograft for unicondylar defects. Currently, polymethylmethacrylate (PMMA) has demonstrated biomechanical advantages for treating non-contained bone defects around the knee, with failure loads exceeding those of a native knee. The aim of this paper is to present two cases in which PMMA plus cannulated screws were used as salvage treatment in the context of non-reconstructable bone defects. One patient developed knee stiffness, which was treated with arthroscopic fibroarthrolysis and mobilization under anesthesia. Both patients achieved an acceptable range of motion after rehabilitation and were able to return to work. In light of the evidence, these salvage techniques may represent a viable option for transitional reconstruction of defects around the knee, offering advantages such as immediate stability, early weight-bearing, low cost, easy reproducibility, and the possibility of immediate local antibiotic treatment.