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Excision arthroplasty with delayed wound closure for the infected total hip replacement
Clinical Orthopaedics and Related Research
|November 1, 1978
Summary
Managing gram-negative infections after total hip replacement requires aggressive treatment. Excision arthroplasty with delayed wound closure offers a viable solution, leading to sepsis-free patients with good functional outcomes.
Area of Science:
- Orthopedic Surgery
- Infectious Disease Management
Background:
- Infections following total hip replacement (THR) present significant management challenges.
- Treatment options range from antibiotics with reimplantation to prosthetic removal.
Observation:
- This study evaluated 10 patients with gram-negative sepsis post-total hip replacement.
- The management protocol involved excision (Girdlestone) arthroplasty with delayed wound closure.
Findings:
- Patients received parenteral antibiotics during open wound management, followed by 6 months of oral antibiotics.
- At 3-5 years follow-up, all patients remained free of clinical sepsis.
- One patient experienced chronic pain, but all achieved full ambulation and satisfaction.
Implications:
- Excision arthroplasty with delayed wound closure is an effective treatment for severe hip replacement infections.
- This approach yields favorable functional results, even with challenging gram-negative organisms.