Could irrigation, debridement and antibiotic therapy cure an infection of a total hip arthroplasty?
Seven patients suffering from an acute (less than two weeks) infection of a total hip arthroplasty were treated by irrigation and debridement, with appropriate antibiotic therapy and retention of the prosthesis. They were followed for an average of 30 months. Infection did not recur in five (71%) patients, but the other two required further surgery. We conclude that a cure can be obtained by this method, although the results are inferior to re-implantation. A minimal procedure spares a patient the morbidity and cost of a more extensive operation. Higher success rates might have been achieved by selecting patients infected with organisms of low virulence, but there are insufficient data to predict whether this treatment would decrease the success of subsequent re-implantation.
Department of Orthopaedics 'A', Tel Aviv Sourasky Medical Centre and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. ekrasin@tasmc.health.gov.il
E
E
Krasin
M
M
Goldwirth
Y
Y
Hemo
A
A
Gold
G
G
Herling
I
I
Otremski
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip; D003428:Cross Infection / Q000382:microbiology / Q000628:therapy*; D003646:Debridement; D005260:Female; D006801:Humans; D008297:Male; D011182:Postoperative Care; D012086:Reoperation; D013530:Surgical Wound Infection / Q000145:classification / Q000382:microbiology / Q000628:therapy*; D007507:Therapeutic Irrigation; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents