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Ureaplasma urealyticum infection in total hip arthroplasty leading to revision

Olof G Sköldenberg1, Agata D Rysinska, Gustaf Neander

  • 1Department of Clinical Sciences at Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.

The Journal of Arthroplasty
|August 14, 2010
PubMed

Insights

Ureaplasma urealyticum infection can rapidly loosen cemented total hip replacements. Consider this infection in cases of rapid, presumed aseptic, loosening during revision surgery.

Area of Science:

  • Orthopedic Surgery
  • Infectious Diseases
  • Microbiology

Background:

  • Cemented total hip arthroplasty (THA) is a common procedure.
  • Rapid loosening of THA, often presumed aseptic, is a challenging complication.
  • Ureaplasma urealyticum is a known pathogen, but its role in THA loosening is not well-documented.

Observation:

  • A case of rapid loosening of a cemented total hip arthroplasty is presented.
  • The loosening was attributed to an infection with Ureaplasma urealyticum.
  • This represents a previously unreported cause of THA loosening in the literature.

Findings:

  • Ureaplasma urealyticum can cause significant bone resorption and implant loosening.
  • Intraoperative cultures for Ureaplasma urealyticum are not standard practice during revision THA.
  • Diagnostic challenges exist in identifying Ureaplasma urealyticum as the causative agent.

Implications:

  • Clinicians should consider Ureaplasma urealyticum infection in the differential diagnosis of rapid THA loosening.
  • Further research is needed to understand the prevalence and pathogenic mechanisms of Ureaplasma urealyticum in orthopedic infections.
  • Development of specific diagnostic and treatment strategies for Ureaplasma urealyticum-related THA complications may be warranted.

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