The arthroscopic drainage, irrigation, and débridement of late, acute total hip arthroplasty infections: average 6-year follow-up.
We present our experience with arthroscopy for the treatment of late, acute periprosthetic hip infections in 8 consecutive patients, treated from 1989 to 1994. After a hip aspiration confirmed the presence of bacterial infection, all patients underwent prompt arthroscopic treatment, which consisted of drainage, lavage, and debridement. Postoperatively, patients were given 2 to 6 weeks of intravenous antibiotics, followed by long-term oral antibiotic suppression. At a mean follow-up of 70 months (range, 29-104 months), no recurrence of infection occurred. No progressive radiographic loosening was noted. Based on this initial study, we believe that arthroscopic irrigation and debridement can benefit well-selected patients who suffer late, acute hip periprosthetic infections. Effective treatment requires early diagnosis, prompt arthroscopic debridement, well-fixed components, a sensitive microorganism, and patient tolerance to and compliance with the antibiotic therapy.
Hyman
J L
JL
Hip/Knee Service, The Hospital for Special Surgery, Cornell University Medical Center, New York, New York, USA.
Salvati
E A
EA
Laurencin
C T
CT
Rogers
D E
DE
Maynard
M
M
Brause
D B
DB
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001182:Arthroscopy; D004322:Drainage; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D059408:Pain Management; D019990:Perioperative Care; D016459:Prosthesis-Related Infections / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D016059:Range of Motion, Articular; D007507:Therapeutic Irrigation
D000900:Anti-Bacterial Agents