Risk factors associated with acute hip prosthetic joint infections and outcome of treatment with a rifampinbased regimen.
OBJECTIVE
Acute prosthetic infection is a serious problem. We report factors related to the incidence of acute infection and results of combined joint debridement and prolonged rifampicin-based antibiotic therapy.


METHODS
Between 1998 and 2004, 14 acute infections occurred after 819 primary hip arthroplasties. The association between patient-related and surgical factors and the risk of infection were analyzed. Infections were treated with multiple joint lavage, debridement, 2 weeks of antibiotic therapy, and then oral antibiotics for a minimum of 6 months.


RESULTS
There was a correlation between having a body mass index (BMI) of >or=30, and also more than 2 co-morbidities, and an increased risk of infection. Diabetes was a potential risk factor. Following our regime of treatment, 11 of 14 patients retained their prosthesis. 2 of 3 who required resection arthroplasty underwent successful staged revision, while the third patient had no further surgery because of being deemed unfit.


CONCLUSIONS
Primary joint replacement was salvaged in 11 of 14 patients. When successful re-implantation was included, 13 of 14 patients had a mobile prosthetic joint without further infection.
Choong
Peter F M
PF
Department of Orthopaedics, University of Melbourne, and Infectious Diseases Unit, St. Vincent's Hospital, Australia. sarcomasurgeon@ozemail.com.au
Dowsey
Michelle M
MM
Carr
Derek
D
Daffy
John
J
Stanley
Peter
P
D000208:Acute Disease; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000382:microbiology; D012086:Reoperation; D012293:Rifampin / Q000627:therapeutic use*; D012307:Risk Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D012293:Rifampin