Reimplantation of infected hip arthroplasties using bone allografts.
Twenty-two patients with deep infection of an hip prosthesis received delayed reimplantation using bone allografts. Sixteen were done using noncemented components and 6 using femoral components that were fixed with antibiotic impregnated cement. Bulk allografts were used at the acetabular site in 2 patients and at the femoral site in 4 patients. Morselized allografts were used at the acetabular site in 20 patients and at the femoral site in 10 patients. The causative organisms were virulent in 10 hips and low virulent in 12 hips. At an average followup of 4 years (range, 2-7 years), 91% of patients were free of infection and 73% had a successful functional result. Two had a recurrent infection; 1 of them had a pseudomonas infection and another had a methicillin resistant Staphylococcal infection. The recurrence of infection tended to be higher if the causative organism was virulent. The use of bone allografts at the staged reimplantation of the infected hip arthroplasty did not increase the incidence of recurrent infection. Both cemented and noncemented reimplantations had a successful result in eradicating the infection. However, hybrid reimplantation with a cemented femoral component and fixed porous acetabular component had a better functional outcome than noncemented reimplantation using porous femoral component and nonfixed acetabular component.
Wang
J W
JW
Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Taiwan, Republic of China.
Chen
C E
CE
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001843:Bone Cements; D016025:Bone Transplantation; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage; D006622:Hip Prosthesis / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000382:microbiology / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D001843:Bone Cements; D005839:Gentamicins