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The infected hip after total hip arthroplasty
The Journal of Bone and Joint Surgery. American Volume
|December 1, 1984
Summary
Treating prosthetic total hip replacement infections is challenging. Surgical intervention, particularly Girdlestone arthroplasty, offers better outcomes than antibiotics alone for eradicating infection and achieving satisfactory clinical results.
Area of Science:
- Orthopedic surgery
- Infectious diseases
Background:
- Prosthetic joint infections are a significant complication of total hip replacement.
- Previous surgeries and wound complications increase infection risk.
Purpose of the Study:
- To analyze clinical features, causative organisms, treatment methods, and long-term outcomes of prosthetic total hip replacement infections.
- To evaluate the efficacy of different treatment strategies.
Main Methods:
- Retrospective study of 52 patients with infected prosthetic total hip replacements.
- Analysis of clinical data, microbiological cultures, treatment approaches, and follow-up results.
Main Results:
- Common infecting organisms included Staphylococcus epidermidis, Staphylococcus aureus, and Escherichia coli.
- Antibiotic therapy alone had a low eradication rate (1/33).
- Excisional arthroplasty eradicated infection in 27/33 patients, with satisfactory outcomes in 20.
- Girdlestone arthroplasty achieved 100% infection eradication and satisfactory outcomes in 10/10 patients.
Conclusions:
- Infected prosthetic total hip replacements require aggressive management.
- Surgical intervention, especially Girdlestone arthroplasty, is superior to antibiotics alone for managing these infections.
- Girdlestone arthroplasty provides excellent infection control and clinical satisfaction in selected cases.