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Erschienen in:
01.06.2015 | Original Paper
Irrigation and debridement for periprosthetic infections of the hip and factors determining outcome
Erschienen in: International Orthopaedics | Ausgabe 6/2015
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Purpose
Our purpose was to identify the success rate and factors predicting outcome of irrigation and debridement (I&D) in patients with deep periprosthetic joint infection (PJI) of the hip.
Methods
We retrospectively reviewed clinical characteristics of patients with deep PJI after primary/revision total hip arthroplasty (THA) between January 2000 and May 2013 treated with I&D. Implant retention was the outcome of interest. Sixty patients (29 men and 31 women; mean age 64.9 years) were identified. Mean follow-up was 59 months (range, 12–168).
Results
The implants were retained in 42 patients (70%). Failure of I&D treatment correlated with duration of symptoms >five days (p <0.001) and obesity [body mass index (BMI) ≥ 30)] (p = 0.0289). Treatment outcome was affected by the type of pathogen (p = 0.0482), with patients with methicillin-resistant staphylococci having significantly lower odds of success.
Conclusions
I&D can be a feasible option in THA patients presenting with acute deep PJI. Duration of symptoms >five days, isolation of methicillin-resistant staphylococci and obesity should be taken into consideration in pre-operative decision making.