The use of two-stage exchange arthroplasty with depot antibiotics in the absence of long-term antibiotic therapy in infected total hip replacement.
We present a series of 114 patients with microbiologically-proven chronically-infected total hip replacement, treated between 1991 and 2004 by a two-stage exchange procedure with antibiotic-loaded cement, but without the use of a prolonged course of antibiotic therapy. The mean follow-up for all patients was 74 months (2 to 175) with all surviving patients having a minimum follow-up of two years. Infection was successfully eradicated in 100 patients (87.7%), a rate which is similar to that reported by others, but where prolonged adjuvant antibiotic therapy has been used. Using the technique described, a prolonged course of systemic antibiotics does not appear to be essential and the high cost of the administration of antibiotics can be avoided.
Stockley
I
I
Sheffield Teaching Hospitals Trust, Herries Road, Sheffield, S5 7AU, UK. Ian.Stockley@sth.nhs.uk
Mockford
B J
BJ
Hoad-Reddick
A
A
Norman
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000191:economics; D019644:Arthroplasty, Replacement, Hip / Q000379:methods; D001843:Bone Cements / Q000191:economics / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D019983:Guideline Adherence; D006621:Hip Joint; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D016459:Prosthesis-Related Infections / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000188:drug therapy*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D001843:Bone Cements