Vastus lateralis flaps for chronic recalcitrant hip infection

Area of Science:

• Orthopedic Surgery
• Infectious Disease Management
• Reconstructive Surgery

Background:

• Chronic recalcitrant hip joint infections pose significant challenges in treatment.
• Previous surgical attempts to eradicate infection averaged 2.8 procedures per patient.
• The average duration of infection prior to flap transposition was 7.9 months.

Purpose of the Study:

• To evaluate the efficacy of vastus lateralis flap transposition for chronic recalcitrant hip joint infections.
• To assess the functional and infectious outcomes following this reconstructive procedure.
• To highlight the advantages of the vastus lateralis flap in hip infection management.

Main Methods:

• Retrospective analysis of 11 patients treated with vastus lateralis flap transposition between January 1991 and May 1994.
• Surgical procedure involved transposition of a vastus lateralis flap to the hip joint.
• Post-operative management included antibiotics and debridement for recurrent drainage in some cases.

Main Results:

• All 11 patients achieved wound healing and resolution of hip joint infection.
• Three patients experienced recurrent drainage, successfully managed with antibiotics and debridement.
• Two patients underwent delayed exchange total hip arthroplasty post-flap transposition.

Conclusions:

• Vastus lateralis flap transposition is a successful treatment for chronic recalcitrant hip joint infections.
• The flap provides a vascularized cushion, potentially preventing proximal femur migration.
• This technique can be combined with Girdlestone arthroplasty or serve as an interim procedure for future total joint arthroplasty.