[Salvage surgery in chronic infection following total hip prosthesis]

Thirteen patients were analyzed who suffered from chronic infection after total hip replacement. Some of them had had severe soft tissue defects or multiple fistulae for years. Some showed acute, sometimes life-threatening infection after long-standing loosening of the prosthesis. Therapy consisted of radical debridement, installation of a closed suction-irrigation drainage system and if another total hip prosthesis was implanted of a specific antibiotic management, including rifampin. In one case treatment was limited to the achievement of a permanent fistula. The average follow-up time was 4.3 years. With or without total hip reimplantation infections were healed as a rule and the decrease in pain was marked. There was only a partial increase in walking ability. In these severely damaged patients treatment can result in marked amelioration of the quality of life but only exceptionally in normalization.