One stage surgical management of deep infection of total hip arthroplasty

Nineteen patients underwent one stage surgical management of infected hip prostheses over a five year period. Thirteen were male and six were female. The mean age was 64 years (Range 49-82). The mean time interval between primary and revision surgery was 26 months (Range 6 months-16 years). One stage re-implantation was performed in 15 patients and excision arthroplasty in 4 patients. The mean duration of follow up was 4 years, 5 months (Range 2-7 years). Patients were assessed, radiologically and clinically using the Harris hip score. Staph. aureus(7) and Slaph. epidermidis(10) were the most frequent organisms isolated. Patients who underwent excision arthroplasty had discharging sinuses, extensive soft tissue and bone involvement or were poor anaesthetic candidates. Three of these patients had a poor outcome in terms of pain function and deformity. Five of the patients who underwent one stage re-implantation had an excellent clinical result, seven had a good result, one had a fair result and one a poor result. There was no recurrence of infection in either group of patients. One stage re-implantation can result in a good clinical outcome and eradication of infection. Resection arthroplasty is a necessary option in a minority of patients, however, while successful in eradicating infection may result in a poor functional outcome.