Patient-Specific PEKK Tibial Implant  

1st lower limb PEKK implant in India

A 12-year-old girl presented with chronic osteomyelitis of the left tibia, complicated by a pathological fracture following previous debridement procedures. Our team planned the procedure in stages, using a customized PEKK implant, a customized titanium nail, and an autologous fibular graft harvested from the patient’s right leg. 

1. Phases of Reconstruction 

• Phase 1: Infection control using antibiotic cement spacer 

• Phase 2: Planning of 3d Implants and Reconstruction 

• Phase 3: Surgery 

2. Pre-condition 

Chronic osteomyelitis of the left tibia and a pathological fracture. 

Phase 1- 30th June 2026 

Placement of an antibiotic cement spacer and culture-specific intravenous antibiotic therapy. 

Phase 2  

A custom PEKK implant was designed, with a plan to integrate it with a tibial nail and an autologous fibular graft harvested from the right leg. 

Phase 3 (2^nd September 2026) 

A second surgery was performed to remove the cement spacer and temporary tibial nail. 

Phase 3.1 

The custom PEKK implant, tibial nail, and right fibular graft were implanted to reconstruct the tibial defect. 

Intraoperative C-Arm Verification 

6 weeks post-surgery 

Postoperative anteroposterior and lateral radiographs documented the reconstructed tibia and fixation construct with stabilized conditions. 

Innovation in Complex Reconstruction 

We successfully completed the case from initial planning through integrating a customized implant, CT-based fixation planning, and autologous bone grafting into a coordinated, 2-stage limb-salvage strategy.