Case study

Transform infected revision arthroplasty

Courtesy of Mr Ramasubramanian Dharmarajan
Cumbria, UK

Clinical particulars

59-year-old female patient presented with infected well fixed total knee replacement two years after primary total knee replacement surgery. This was an acute presentation with  all clinical features of infection with samples testing positive for Group B Streptococcus.


First stage – radical debridement, implant removal and insertion of antibiotic-loaded  cement spacer and  STIMULAN beads mixed with vancomycin.

Second stage – At 10 weeks, clinically soft  tissues were healthy and intra-operative specimens were clear for organisms. Rotating  hinge prosthesis was re-implanted.


At 1 year follow-up the patient remains infection free and is under regular follow-up.


For indications, contraindications, warnings and precautions see Instructions for Use.  The treating physician is responsible for deciding the type and quantity of antibiotic used.  Concurrent use of locally administered antibiotics may affect setting time.

The mixing of antibiotics with the STIMULAN Kit / STIMULAN Rapid Cure device is considered off-label usage of the medicinal product. To do so is at the professional risk of the surgeon / healthcare professional.

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Patents granted: GB2367552, EP 1204599 B1, US 6780391, EP 2594231 B1, US 8883063, CN ZL201210466117.X, GB2496710, EP 3058899 B1

Patents pending: GB1502655.2, US 15/040075, CN 201610089710.5, US 15/288328, GB1704688.9, EP 18275044.8, US 15/933936

Dharmarajan case study