[Femorotomy and cleaning for infected hip prostheses: report of 30 cases].
OBJECTIVE
We report infected hip prostheses treated by an original technique: frontal femorotomy after trochanterotomy.


METHODS
This extensive technique enables perfect cleaning of the femur and truly effective freshening of the endomedullar canal. We report 30 cases operated since 1991 use of femorotomy has been systematic from 1995.


RESULTS
We were able to reimplant 25 of these 30 hips. Our results after infection were rather good with 4 recurrent infections in difficult cases (multi-operated patients and multiresistant germs in half of the cases). Fusion of femorotomy was obtained in all cases. The mechanical outcome was not improved by femorotomy. The main problem was trochanter nonunion with 5 cases, all of them having had a trochanteromy during the first procedure.


CONCLUSIONS
We use femorotomy as our routine technique for femoral cleaning in case of hip prosthesis infection. In less complicated cases, we do not remove the trochanter from the femoral valve, limiting trochanteric complications, the main problem with this technique.
Lortat-Jacob
A
A
Service de Chirurgie Orthopédique et Traumatologique, Hôpital Ambroise-Paré, CHU Paris Ouest, 92100 Boulogne.
Nourrissat
G
G
Cadu
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004203:Disinfection; D005260:Female; D005269:Femur / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D016459:Prosthesis-Related Infections / Q000628:therapy*