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Published on: September 7, 2022
[Our experience with the removal of infected hip arthroplasty.]
Insights
Removal of infected hip arthroplasty often results in significant leg shortening and poor functional outcomes, with a notable 18% recurrence rate of infection. This procedure is a last resort, not without risks.
Area of Science:
- Orthopaedic Surgery
- Infectious Disease Management
Context:
- Periprosthetic joint infections (PJIs) pose a significant challenge in hip arthroplasty.
- Removal of infected hip arthroplasty is a treatment option, but its long-term outcomes require thorough evaluation.
Purpose:
- To assess the functional outcomes and complication rates following the removal of infected hip arthroplasty.
- To evaluate the recurrence rate of infection after infected hip arthroplasty removal.
Summary:
- A follow-up study of 23 patients after infected hip arthroplasty removal showed an average Harris Hip Score of 57.5, with no excellent outcomes.
- Patients experienced significant lower limb shortening (average 5 cm) and functional limitations, with 18% experiencing recurrent infections within 3.3 years.
Impact:
- Highlights the functional deficits and risks associated with infected hip arthroplasty removal.
- Emphasizes the need for careful consideration of this procedure as a final treatment option for periprosthetic infections.
Abstract:
In total 67 infected hip arthroplasties in the group of 26 men and 41 women were removed at the Orthopaedic Clinic in Hradec Králové in the period of 1984-1998.Twenty three patients (11 men and 12 women) showed up for the follow up with an average period of 5 years after the removal of the implant.The follow up consisted in the examination of the range of movements and a protocol was filled in. The acquired data then served for the calculation of the Haris score of the hip joints operated on. Seven patients had no pain, slight or moderate pain not affecting the daily routine activities were reported by 10 patients. However, none of the patients was able to walk without support and a significant shortening of the lower limb operated on was found with the average value of 5 cm. The average rating based on the total evaluation of the hip joint according to the Harris Hip Score was 57,5 points, no hip joint after the removal of arthroplasty was assessed as excellent. Removal of hip arthroplasty as a final solution of periprothetic infect remains at present one of the possibilities of the treatment, however, not even this operation is quite without a risk of the recurrence of infect. In the group of 61 patients followed up after the removal of infected hip arthroplasty we recorded retrospectively in the average interval of 3 years and 4 months after the extraction 11 cases of the recurrence of infect (i. e. 18 %). Key words: infected hip arthroplasty, removal of infected hip arthroplasty.