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Related Experiment Videos

Total hip replacement in the previously septic hip.

D L Cherney, H C Amstutz

    The Journal of Bone and Joint Surgery. American Volume
    |December 1, 1983
    PubMed
    Summary
    This summary is machine-generated.

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    Total hip replacement for active sepsis shows a 70% success rate, with gram-positive infections faring better than gram-negative ones. Repeat antibiotics post-surgery can improve outcomes, but careful patient selection is crucial.

    Area of Science:

    • Orthopedic Surgery
    • Infectious Diseases
    • Biomedical Engineering

    Background:

    • Active sepsis in the hip joint presents a significant challenge for total hip replacement (THR).
    • Previous hip surgeries or trauma can increase the risk of infection during THR.
    • Hematogenous spread or direct inoculation can lead to hip joint destruction by sepsis.

    Purpose of the Study:

    • To evaluate the success rates of one- or two-stage total hip replacement in patients with active hip sepsis.
    • To identify factors influencing prosthetic failure and success in infected hips.
    • To assess the efficacy of different treatment strategies and diagnostic methods.

    Main Methods:

    • Retrospective analysis of 33 patients undergoing one- or two-stage THR for active sepsis.

    Related Experiment Videos

  • Categorization of sepsis origins, including post-arthroplasty, post-fracture fixation, and hematogenous spread.
  • Evaluation of infection recurrence, prosthetic failure, and functional outcomes at 3-9 years post-surgery.

    • Main Results:

    • Overall success rate of 70% (23 out of 33 hips) with no signs of infection post-replacement.
    • Higher success rates (78%) for gram-positive infections compared to gram-negative infections (58%).
    • Prosthetic failure was highest in patients with prior THR infections (37%) and lowest in those with infected hemiarthroplasty (16%).

    Conclusions:

    • Total hip replacement can be successful in managing active hip sepsis, particularly with gram-positive organisms.
    • Repeat parenteral antibiotics post-THR may improve success rates, even with negative preoperative/intraoperative findings.
    • Careful patient assessment is vital due to high failure rates, especially with gram-negative infections like Pseudomonas.