[Antibiotic therapy in hip endoprosthesis surgery]

Area of Science:

• Orthopedic Surgery
• Infectious Disease Prevention
• Biomedical Engineering

Context:

• Deep periprosthetic joint infection (PJI) is a significant complication following total hip replacement (THR).
• Optimizing infection control strategies is crucial for improving patient outcomes and reducing healthcare costs.
• Previous methods often relied on prophylactic antibiotics, which can lead to resistance.

Purpose:

• To present and evaluate a comprehensive 5-point program designed to prevent deep infection after total hip replacement.
• To assess the efficacy of a specific infection prevention protocol, including laminar air flow and localized/alternating antibiotic administration.
• To analyze infection rates in a large cohort undergoing single-stage THR procedures.

Summary:

• A 5-point program for preventing deep infection after total hip replacement (THR) was analyzed in 3948 single-stage procedures.
• The protocol utilized laminar air flow without prophylactic antibiotics, achieving a 0.07% early infection rate and 1.29% long-term.
• For deep periprosthetic infection, one-stage reimplantation with local and alternating systemic antibiotics showed an 80% recurrence-free rate over 1-9 years.

Impact:

• This program offers a highly effective, potentially antibiotic-sparing approach to minimize deep infection risk in THR.
• The findings support the implementation of this multi-faceted strategy in orthopedic surgical settings.
• Successful prevention and management of PJI can significantly improve patient quality of life and reduce revision surgery rates.