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Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction

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Deep infection in total hip arthroplasty.

Henry Hamilton¹, John Jamieson

¹Port Arthur Health Centre, Lakehead University, Thunder Bay, Ontario, Canada. drhenryhamilton@hotmail.com

Canadian Journal of Surgery. Journal Canadien De Chirurgie

|April 2, 2008

Summary

Deep infection risk after total hip arthroplasty doubles from 2 to 20 years. Key predictors include specific radiologic findings, elevated erythrocyte sedimentation rate, alcoholism, and blood transfusions.

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Area of Science:

Orthopedic Surgery
Infectious Disease Epidemiology

Background:

Deep infection is a significant complication following total hip arthroplasty (THA).
Long-term prospective data on infection rates and risk factors are crucial for improving patient outcomes.

Purpose of the Study:

To investigate the incidence and predictors of deep infection over 30 years in a large cohort of primary total hip arthroplasties.
To identify modifiable and non-modifiable risk factors associated with deep infection after THA.

Main Methods:

A 30-year prospective study of 1993 consecutive total hip arthroplasties performed by a single surgeon.
Analysis of numerous variables to determine their relationship with the incidence of deep infection.

Main Results:

The cumulative infection rate increased from 0.8% at 2 years to 1.4% at 20 years (index procedures).
Significant predictors of infection included specific radiologic diagnoses (upper pole grade III, protrusio acetabuli), elevated erythrocyte sedimentation rate, alcoholism, and units of blood transfused.
Infections attributed to secondary surgeries increased the overall infection rate to 2% at 20 years.

Conclusions:

The incidence of deep infection in THA significantly increases between 2 and 20 years postoperatively.
Preoperative identification of risk factors allows for targeted prophylactic measures.
Anesthesia choice (spinal/epidural) may reduce blood transfusion requirements, a key risk factor. Clean air technology efficacy was supported.

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Last Updated: Jul 6, 2026

Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction

Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction

Published on: December 3, 2017