One stage revision arthroplasty of the hip for deep gram negative infection

We describe the use of one stage revision arthroplasty of the hip for deep gram negative infections. We have followed up 15 patients for an average of 8 years following operation. Two procedures failed, one at two years due to aseptic loosening and another because of persistent infection. We attribute the low reinfection rate (1/15) to meticulous surgical technique, preoperative parenteral antibiotics and antibiotic loaded cement. Both failures occurred in the two operations performed without antibiotic loaded cement. We do not recommend the use of plain cement for exchange hip arthroplasty in the presence of gram negative infection.