One-stage revision of infected total hip arthroplasty with bone graft.
There are many different opinions in the literature regarding the best procedure for revision of infected hip arthroplasty and hence in achieving long-term stabilization of a new implant. Thirty-two patients with 32 loose and infected total hip arthroplasties underwent revision with a bone graft in a 1-stage procedure. The bone graft was used in the acetabulum and femur in 25 patients, in the acetabulum alone in 4 patients and in the femur alone in 3 patients. A metal mesh was necessary in 15 patients to contain the morselized bone graft. At the time of surgical revision, 9 patients had a draining sinus, 6 had a closed sinus, and 17 had never had sinuses in the surgical wound. Antibiotic therapy was administered intravenously and orally for 6 months. Mean follow-up was 103 months (range, 63-183 months), and infection recurred in 2 (6.2%) cases. Further studies are necessary, and continuation of this method is justified.
Department of Orthopaedic Surgery, Santa Casa Medical School, São Paulo, Brazil.
Sergio
S
Rudelli
David
D
Uip
Emerson
E
Honda
Ana Lucia L M
AL
Lima
D000077:Acetabulum / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D016025:Bone Transplantation / Q000379:methods*; D002939:Ciprofloxacin / Q000627:therapeutic use; D002981:Clindamycin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D005269:Femur / Q000601:surgery; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000382:microbiology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000601:surgery*; D011859:Radiography; D012086:Reoperation / Q000379:methods*; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000601:surgery; D013210:Staphylococcus; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D002981:Clindamycin; D002939:Ciprofloxacin