Antibiotic Delivery via Hickman Catheter for the Treatment of Prosthetic Joint Infection

Infection rates for total joint arthroplasty range from 1% to 2%, and infection carries significant risk. The traditional course of treatment is irrigation and debridement, but historically, success rates have been variable. The goals of this study were to evaluate the safety and efficacy of Hickman catheterization in the treatment of prosthetic joint infection and to assess its value as an alternative to irrigation and debridement. The authors retrospectively analyzed 26 Hickman catheterizations in the treatment of acute early, acute late, and chronic late infections of primary and revision hip and knee arthroplasty. Initial arthroplasty procedures were performed between 2006 and 2018, with all cases followed for a minimum of 1 year postoperatively. The authors evaluated surgical data, clinical outcomes, and success rates, and they compared their success rates with reported values for cases treated with irrigation and debridement. The authors' success rate was 100% for acute early hip infection, 100% for chronic knee infection, and 80.0% for chronic hip infection. They reported a 75.0% success rate in the treatment of acute late infection for hip arthroplasty and a rate of 62.5% for knee arthroplasty. Postoperative clinical outcomes were significantly improved for both hips and knees for all infection types. The success rates for the treatment of acute early prosthetic joint infection and chronic late prosthetic knee infection were superior to available reported rates on irrigation and debridement. The authors also reported the highest success rate for the treatment of acute late infection. The current data suggest that Hickman catheterization is a promising safe and effective alternative to irrigation and debridement for the treatment of prosthetic joint infection. [Orthopedics. 2021;44(3):e395-e401.].