[Local antisepsis in infected total hip endoprosthesis]

Area of Science:

• Orthopedic Surgery
• Infectious Disease Management

Background:

• Total hip prostheses are susceptible to infection post-implantation.
• Effective treatment strategies for infected prostheses are crucial for patient outcomes.

Observation:

• A study evaluated 34 infected total hip prostheses treated with hexamethylenbiguanide (Lavasept) alongside surgical intervention.
• Treatment groups included early hematoma management, soft tissue revision, one-stage prosthesis exchange, and prosthesis removal.

Findings:

• Success rates varied by treatment group: 100% for early hematoma management, 20% for soft tissue revision, and 77% for one-stage exchange.
• Prosthesis removal was performed in severe cases, with mixed outcomes including one fatality and two uneventful healing.
• Hexamethylenbiguanide demonstrated utility as an adjunct to surgical revision for infected hip prostheses.

Implications:

• Topical hexamethylenbiguanide may improve outcomes for infected hip prostheses when used with surgical débridement and antibiotics.
• Further research with longer follow-up periods is necessary to fully establish the long-term efficacy and safety of this antiseptic approach.
• This study highlights the importance of tailored treatment strategies based on the severity and timing of prosthetic joint infections.