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Erschienen in: Archives of Orthopaedic and Trauma Surgery 10/2018

19.06.2018 | Orthopaedic Surgery

Total hip arthroplasty following illicit drug abuse

verfasst von: Tim Ramczykowski, Christiane Kruppa, Thomas Armin Schildhauer, Marcel Dudda

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 10/2018

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Abstract

Background

The role of illicit drug abuse in total joint arthroplasty is largely unknown and is likely underestimated. Patients with drug addictions often suffer from septic osteoarthritis or a necrosis of the femoral head. Purpose of the study was to evaluate the operative management and clinical outcome of total hip replacement in patients with a history of intravenous drug abuse.

Methods

This retrospective study included 15 patients with a history of intravenous drug abuse who underwent total hip arthroplasty. A total of 6 females and 9 males with an average age of 34.3 years were identified. Ten patients presented an acute bacterial coxitis (Coxitis-group) and five an aseptic osteonecrosis of the femoral head (Osteonecrosis-group).

Results

Ten patients with a bacterial coxitis underwent a two-staged total hip arthroplasty (THA), with temporary insertion of a drug-eluting spacer. Five patients with a necrosis of the femoral head were primarily treated with THA. All patients developed multiple re-infections after insertion of a drug-eluting spacer or THA. Only two patients finally achieved a THA without infection in the period of 3.9 years follow-up. The other 13 patients underwent a Girdlestone arthroplasty (7 patients) or total joint replacement with a chronic fistula (6 patients).

Conclusion

THA in patients with illicit drug abuse shows a low success rate. Following septic osteoarthritis or osteonecrosis in drug-addicted patients, we recommend a two-stage procedure with temporary insertion of a drug-eluting spacer. THA might follow only under strict premises.
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Metadaten
Titel
Total hip arthroplasty following illicit drug abuse
verfasst von
Tim Ramczykowski
Christiane Kruppa
Thomas Armin Schildhauer
Marcel Dudda
Publikationsdatum
19.06.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Orthopaedic and Trauma Surgery / Ausgabe 10/2018
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-018-2980-3

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