Case study

Transform talonavicular septic arthritis

Courtesy of Mr Mark Davies, Consultant Orthopaedic Surgeon
Sheffield, UK

Clinical particulars

27-year-old female presented with spontaneous symptoms and signs suggestive of isolated talonavicular septic arthritis. This was treated by an open arthrotomy and washout. Staphylococcus aureus was grown from the joint and found to be sensitive to gentamicin and flucloxacillin. The surgical treatment and a 6 week course of oral antibiotic therapy resolved the acute infection. Unfortunately, as a result of the septic arthritis, the patient experienced ongoing pain from the talonavicular joint such that 18 months after the infective episode, she sought treatment for the pain. Plain radiographs showed a narrowed joint line at the talonavicular joint. No other investigations  suggested ongoing presence of infection.



The patient underwent a talonavicular fusion utilising the incision for the index surgery. After thorough debridement by resection of the articular surfaces with chisels, further tissue samples were taken. Given the sensitivities of the original organism, STIMULAN paste was injected into the joint with locally administered gentamicin before compression across the joint was applied with the internal fixation.



At 6 months’ follow-up, the arthrodesis procedure was successful and the patient remains pain free.


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 has not been assessed by a European medicines Competent Authority and is considered off-label usage of the medicinal product. To do so is at the professional risk of the surgeon / healthcare professional.

This brochure may include the use of STIMULAN or techniques that go beyond the current clearance / approval granted by the relevant regulatory authority. Please contact your local representative for further information.

©2018, Biocomposites, STIMULAN, Bringing Calcium to Life, Power to Transform Outcomes and DRy26 are trademarks/registered trademarks of Biocomposites Ltd. All rights reserved. No unauthorised copying, reproduction, distributing or republication is allowed unless prior written permission is granted by the owner, Biocomposites Ltd.

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