Management of failed total hip arthroplasty with muscle flaps

In the small percentage of deep wound infections complicating total hip arthroplasty and recalcitrant to conventional forms of treatment, muscle flaps with or without a cutaneous unit can offer a satisfactory solution. Seven patients (4 male, 3 female) with failed total hip arthroplasty and multimicrobial infection were treated with a rectus femoris or vastus lateralis flap or with combined muscle transposition flaps. The patients had had from 6 to 25 surgical procedures after the failed total hip arthroplasty and before the muscle flap. The mean duration of the postsurgical hospital stay after the muscle flap procedure was thirty-one days. The mean follow-up was thirty months. Two postoperative complications occurred, one of which required partial debridement of the transposed muscle. All patients had healed wounds at follow-up. All patients were weight bearing at follow-up; 3 had been unable to bear weight before the operation. No patient showed incapacity related to the muscle transposition procedure.