[Replacement of infected total hip prosthesis in two stages].
Since 1975 we have treated 36 infected hip replacements by a two stage procedure in which the prosthesis and cement were first removed. Gentamicin impregnated beads were left at the sites of the prosthesis. Not less than 45 days later a fresh prosthesis was inserted into the hip. In two hips revision was not undertaken because of persistence of infection. The remaining 34 hips received a fresh prosthesis when the site was bacteriologically sterile. Gentamicin impregnated cement was used and antibiotics were given for a further three months. The functional results were satisfactory at an average of five years of follow up. Incomplete removal of methylmethacrylate was a factor in the persistence of infection and of pain in the absence of infection. The bacteriological efficacy of Gentamicin impregnated beads is uncertain, but their use gave a better functional result.
Lenoble
E
E
Département d'Orthopédie et de Traumatologie, Hôpital Henri Mondor, Créteil, France.
Goutallier
D
D
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001843:Bone Cements; D005839:Gentamicins / Q000008:administration & dosage / Q000627:therapeutic use*; D006622:Hip Prosthesis / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D016459:Prosthesis-Related Infections / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*; D012086:Reoperation / Q000379:methods
D000900:Anti-Bacterial Agents; D001843:Bone Cements; D005839:Gentamicins