Management of infected prostheses

A retrospective actuarial analysis of 825 onestage reimplantations using antibiotic-loaded acrylic cement for infected total hip replacements is presented. Staphylococcus aureus was the most commonly encountered organism. Failure rates of prostheses infected by S. aureus, Staphylococcus species, and anaerobic Corynebacteria did not differ statistically. A factor that significantly contributed to failure of this method of treatment was Pseudomonas infection. By actuarial analysis (with a twoyear minimum followup) at five years after operation 23% of the implants had failed, and at 11 years, 50%. This compares to a 77% success rate implied by conventional arithmetic.