[Periprosthetic infection after hip arthroplasty]

Area of Science:

• Orthopedic surgery
• Infectious diseases
• Microbiology

Context:

• Periprosthetic infections (PPI) are complex complications in hip arthroplasty, occurring in approximately 1% of primary and 4% of revision surgeries.
• PPI can arise from intraoperative contamination or hematogenous seeding, presenting diagnostic and therapeutic challenges.

Purpose:

• To provide an evidence-based overview of current diagnostics and therapy for hip periprosthetic joint infections (PPI).
• To establish a clear treatment algorithm for managing hip PPI.

Summary:

• Active exclusion of PPI is necessary for painful prostheses or loosening signs.
• Standard diagnostics include joint aspiration, culture, leukocyte counts, and tissue analysis; implant sonication is a newer, effective method.
• Treatment depends on biofilm maturity, prosthesis stability, causative organism, and soft tissue condition, often requiring prosthesis exchange and biofilm-active antibiotics.

Impact:

• Highlights the importance of an exact algorithm for successful PPI diagnostics and therapy.
• Emphasizes the decisive role of interdisciplinary cooperation between infectious disease specialists and microbiologists.