The management of concomitant septic arthritis of the knee and femoral osteomyelitis – A case series and literature review

We present a case series comprising three patients with concomitant septic arthritis of the knee and osteomyelitis of the femur. Early advanced imaging rendered the accurate diagnosis of the condition and the appropriate surgical approach and technique used to treat the infection. Repeated extensive surgical debridement, irrigation and insertion of antibiotic-impregnated cement rod into the femur were required, in addition to long term antibiotics. The infection in all three cases was eradicated successfully. Following a period of physical rehabilitation, they had fairly preserved independent ambulatory function. We advocate a high index of suspicion of this condition with subsequent early advanced imaging for a timely diagnosis. In addition, we described our challenges in the fabrication process of the antibiotic-impregnated cement rod. •Concomitant knee septic arthritis and femoral osteomyelitis is rare.•A high index of suspicion is required for diagnosis of this condition.•Advanced imaging with MRI helps identify this condition in a timely manner.•Surgical debridement is necessary for complete eradication of infection.•The antibiotic-impregnated cement rod is effective in treating femoral osteomyelitis.