Long-Term Outcome of Treating Periprosthetic Hip Joint Infection with Local Antibiotics Delivered Through...

Background/Objectives: This study explores the long-term clinical outcomes of antibiotic-impregnated calcium hydroxyapatite (CHA) as an antibiotic delivery system in treating periprosthetic joint infection (PJI) following total hip arthroplasty (THA). Methods: We conducted a retrospective analysis of 12 patients (13 hips) who were treated with antibiotic-impregnated CHA for PJI after THA and followed for more than 10 years at our institution between 1999 and 2011. The study group comprised six men (seven hips) and six women, with a mean age of 61.4 years. Results: The mean follow-up duration was 13.8 years. After irrigation and debridement with modular component exchange, seven hips in six patients underwent revision surgery; however, PJI relapsed in two hips of two patients with a history of diabetes. Two-stage revision surgery was performed on the two relapsed hips and six scheduled hips with antibiotic-impregnated CHA used to treat all cases of PJI. Infection control (100% rate) was achieved in all joints, and revision surgeries were completed. Two patients died 12 years after the initial procedure, and one died 14 years after the first procedure due to unrelated internal diseases; no infection recurrence was observed. No complications related to antibiotic-impregnated CHA were observed. Conclusions: Our results indicate that antibiotic-impregnated CHA is associated with high success rates in treating PJI after THA, even in cases with advanced disease, and yields satisfactory functional outcomes postoperatively.