Treatment of Infected Total Hip Arthroplasty With a 2-Stage Reimplantation Protocol: Update on “Our Institution's” Experience From 1989 to 2003
Section snippets
Materials and Methods
All 132 cases of infected THAs treated at our institution between 1989 and 2003 were screened for inclusion. At the time of the study, 34 patients were deceased without 2 years of follow-up (either passed away <2 years postoperatively or passed away before they could be contacted for follow-up). Records for 2 of these 34 patients were unavailable. Of the remaining 32 patients, 19 (59.4%) were able to undergo reimplantation surgery and 28 (87.5%) were free of infection at an average of 7.2
Results
There were 82 patients (84 hips) who completed the entire protocol, including 48 men (58.5%) and 34 women (41.5%). The average age at index THA was 54.7 years (range, 17-81 years) and the average age at removal was 61.8 years (range, 32-86 years). The average follow-up duration was 64.8 months with a range from 24 months (the minimum for inclusion) to 203.5 months. The diagnosis that prompted the initial hip arthroplasty was most commonly osteoarthritis, which afflicted 59.5% of hips (50/84). A
Discussion
Our institution was one of the first to study reimplantation of infected THA in the United States 6, 8, 17, 18, 19, 20. In the initial study, Wilson et al. 17, 18 reported on 19 patients treated with complete removal of all foreign material in the hip followed by reconstruction in a second operative session. There were 2 recurrences of infection after an average of 8 years of follow-up (range, 6-9 years). A more extensive follow-up study [19] reviewed each case individually and made
References (24)
- et al.
The arthroscopic drainage, irrigation, and debridement of late, acute total hip arthroplasty infections: average 6-year follow-up
J Arthroplasty
(1999) - et al.
Prolonged suppression of infection in total hip arthroplasty
J Arthroplasty
(1988) - et al.
Current concepts review: infection after total hip arthroplasty
J Bone Joint Surg Am
(1995) - et al.
Instructional course lecture: treatment of infection at the site of total hip replacement
J Bone Joint Surg Am
(1997) - et al.
Instructional course lecture: evaluation and treatment of infection at the site of a total hip or knee arthroplasty
J Bone Joint Surg Am
(1998) - et al.
Two-stage reimplantation of total joint infections
Clin Orthop Relat Res
(2004) - et al.
Antibiotic-impregnated cement spacers for the treatment of infection associated with total hip or knee arthroplasty
J Bone Joint Surg Am
(2007) - et al.
Reimplantation in infection
Clin Orthop Relat Res
(1982) - et al.
The incidence of deep prosthetic infections in a specialist orthopaedic hospital: a 15-year prospective surgery
J Bone Joint Surg Br
(2006) - et al.
Treatment of the infected total hip arthroplasty with a two-stage reimplantation protocol
Clin Orthop Relat Res
(1994)
Two-stage revision hip arthroplasty for infection: comparison between the interim use of antibiotic-loaded cement beads and a spacer prosthesis
J Bone Joint Surg Am
Two-stage uncemented revision hip arthroplasty for infection
J Bone Joint Surg Br
Cited by (102)
Current Concepts on the Clinical and Economic Impact of Periprosthetic Joint Infections
2024, Orthopedic Clinics of North AmericaPatient mortality after total hip arthroplasty revision surgery
2024, Journal of OrthopaedicsImpact of Antibiotic-Impregnated Spacer Design in the Treatment of Periprosthetic Hip Infection
2022, Arthroplasty TodayScrew augmented cement spacer for deficient acetabulum in periprosthetic infection following Total Hip Arthroplasty
2022, Orthopaedics and Traumatology: Surgery and Research
No benefits or funds were received in support of the study.