Emergency hemipelvectomy as a result of uncontrolled infection after total hip arthroplasty: two case reports.
Described are 2 patients with sepsis caused by an infection of a total hip arthroplasty. In both cases, the infection involved spread to the ipsilateral retroperitonial and proximal femur soft tissues, and substantial parts of the osseous hemipelvis and proximal femur. Furthermore, the infection could not be controlled despite repeated surgical interventions. Progression of the infection of soft tissue and bone resulted in severe bone stock loss, contractures of hip and knee, and severe neurologic deficit of the involved limb. Hemipelvectomy was indicated as a life-saving procedure. Reluctance to perform vigorous debridement, including removal of the components, can lead to a local spread of the infection, resulting in an uncontrollable process leading to a life-threatening situation.
Krijnen
Matthijs R
MR
Department of Orthopedic Surgery, VU Medical Center, Amsterdam, The Netherlands.
Wuisman
Paul I J M
PI
D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D005260:Female; D006428:Hemipelvectomy; D006801:Humans; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000601:surgery*