Treatment of infected joint arthroplasty

Sixty-two patients presented with an infected total hip arthroplasty. Their management depended on their general medical condition, the clinical signs of infection, the type of infection, the degree of fixation of the components and the available bone stock. Treatment consisted of one of the following: debridement and lavage without removing the prosthesis, one or two stage revision arthroplasty, or excision arthroplasty. There were 11 early and 51 late infections. The commonest bacterium isolated was Staphylococcus epidermidis (30%). Primary revision of the femoral component was slightly more successful with a cemented prosthesis than with an uncemented prosthesis. The overall success rates for cemented and uncemented femoral components were roughly comparable (91.5%:90%). We make various recommendations for the management of infected total hip arthroplasties based on our experience.