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Periprosthetic joint infections after total hip replacement: an algorithmic approach
Mohamed Sukeik1, Fares Sami Haddad2
1Foothills Medical Centre, 1403 29 St NW Calgary, AB T2N 2T9, Canada.
SICOT-J
|March 1, 2019
Summary
A structured algorithm for periprosthetic joint infections after total hip replacement can enhance treatment success. This approach may improve infection eradication rates in various PJI cases.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Biomedical Engineering
Background:
- Periprosthetic joint infections (PJIs) are serious complications following total hip replacement (THR).
- Effective management of PJIs requires a systematic approach to improve patient outcomes.
- Current treatment strategies vary depending on infection type and implant fixation.
Purpose of the Study:
- To present a comprehensive algorithm for managing diverse types of PJIs after THR.
- To outline a protocol for addressing acute and chronic PJIs, including those with well-fixed or loose components.
- To evaluate the efficacy of a single-stage revision approach in selected chronic PJI cases.
Main Methods:
- Development of a multidisciplinary algorithm for PJI management.
- Application of the algorithm to different PJI scenarios: acute infections (cemented/cementless), haematogenous spread, and chronic infections.
- Utilisation of a single-stage revision procedure in a selected subset of patients with chronic PJIs.
Main Results:
- The proposed algorithm aims to standardize PJI management.
- The algorithm addresses acute PJIs in well-fixed implants and chronic PJIs with loose components.
- A single-stage revision demonstrated high infection eradication rates in carefully selected patients.
Conclusions:
- A structured, multidisciplinary algorithm can optimize the management of periprosthetic joint infections after total hip replacement.
- The algorithm provides a framework for treating various PJI presentations, including acute and chronic cases.
- Single-stage revision is a viable option for infection eradication in highly selected patients with chronic PJIs.
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