Two-stage revision of infected hip arthroplasty using a shortened post-operative course of antibiotics.
BACKGROUND
We present a series of 30 consecutive patients with 31 infected total hip arthroplasties treated by a single surgeon over a 4-year period in whom a shortened post-operative course of antimicrobial chemotherapy was used.


METHODS
The treatment protocol consisted of a two-stage exchange with removal of infected components, insertion of an interim antibiotic eluting cement spacer and re-implantation of an extensively coated uncemented prosthesis on the femoral side. Systemic antibiotic treatment following each stage consisted of an abridged course of 5 days post-operative intra-venous administration followed by complete cessation of anti-microbial therapy.


RESULTS
At a mean follow-up of 35 months (minimum 24 months), there were no cases of recurrent prosthetic infection and no patient had required revision for aseptic loosening or mechanical instability on the femoral side. The combination of effective-staged surgical joint debridement, a shortened post-operative course of systemic antibiotic treatment and an adequate latent period before re-implantation has led to encourage early results in this series of revised chronic hip joint prosthetic infections.
McKenna
Paul B
PB
Department of Orthopaedic Surgery, Mid-Western Regional Orthopaedic Hospital, Croom, Ireland. paul.mckenna@ul.ie
O'Shea
Keiran
K
Masterson
Eric L
EL
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D001843:Bone Cements; D003646:Debridement; D005260:Female; D006621:Hip Joint / Q000382:microbiology; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000382:microbiology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies
D000900:Anti-Bacterial Agents; D001843:Bone Cements