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[Early-onset infection after hemiarthroplasty of the hip: an algorithm for surgical therapy]
1Abteilung für Chirurgie, Standort Eggenfelden, Rottal-Inn-Krankenhäuser, Simonsöder Allee 20, 84307 Eggenfelden. marcwick@web.de
Background:
In a retrospective study, we compared the results of different surgical therapies in 30 patients who had an early-onset infection after implantation of a hip hemiarthroplasty.
Material And Methods:
Patients were divided into two groups: In group 1 (n=16, deep infection), we changed the polyethylene inlay as well as the femoral head. In group 2 (n=14, deep infection), an acetabular component was also implanted.
Results:
In group 1, successful treatment was achieved in 37.5% of patients 6 months after the last operation, compared with 71.4% in group 2 (p=0.019). All patients were supported with antibiotics. In group 1, three patients died from septic multiorgan failure. Two patients in group 1 and one patient in group 2 received a Girdlestone operation.
Conclusions:
These results suggest that aggressive surgical treatment with soft tissue revision, lavage, and implantation of an acetabular component in combination with antibiotics is a useful technique for treating early-onset infection.