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Deep infection after hip arthroplasty: staying current with change

M R Whitehouse1, M C Parry2, S Konan3

  • 1University of Bristol, Southmead Hospital, Bristol, BS10 5NB, UK.

The Bone & Joint Journal
|January 7, 2016
PubMed

Insights

Periprosthetic joint infection (PJI) affects 0.5-1.2% of hip replacements. This review updates on PJI diagnosis, treatment challenges, resistant microbes, and evidence gaps for total hip arthroplasty care.

Area of Science:

  • Orthopedics
  • Infectious Diseases
  • Biomedical Engineering

Background:

  • Periprosthetic joint infection (PJI) is a severe complication following total hip arthroplasty (THA), occurring in 0.5% to 1.2% of primary procedures.
  • PJI can lead to devastating consequences, necessitating complex management strategies.
  • Traditional diagnostic methods include serological inflammatory markers and joint fluid microbiological analysis.

Purpose of the Study:

  • To provide an updated overview of the burden of periprosthetic joint infection (PJI) after total hip arthroplasty (THA).
  • To review current diagnostic and treatment strategies for PJI.
  • To highlight challenges posed by resistant organisms and the need for evidence-based treatment guidelines.

Main Methods:

  • Literature review and synthesis of recent studies on PJI.
  • Analysis of diagnostic approaches, including serological markers and microbiological sampling.
  • Evaluation of treatment modalities such as debridement and staged or one-stage revision arthroplasty.

Main Results:

  • PJI remains a significant complication with substantial patient impact.
  • Diagnostic accuracy and treatment efficacy are continually evolving.
  • The emergence of antibiotic-resistant organisms presents a growing challenge in PJI management.

Conclusions:

  • There is a critical need for robust, evidence-based guidelines to direct the management of PJI after THA.
  • Further research is required to address treatment uncertainties, particularly concerning resistant pathogens.
  • Optimizing PJI diagnosis and treatment is essential for improving patient outcomes in THA.
Keywords:
Total Hip Replacement; Infection

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