[Early-onset infection after hemiarthroplasty of the hip: an algorithm for surgical therapy].
BACKGROUND
In a retrospective study, we compared the results of different surgical therapies in 30 patients who had an early-onset infection after implantation of a hip hemiarthroplasty.


METHODS
Patients were divided into two groups: In group 1 (n=16, deep infection), we changed the polyethylene inlay as well as the femoral head. In group 2 (n=14, deep infection), an acetabular component was also implanted.


RESULTS
In group 1, successful treatment was achieved in 37.5% of patients 6 months after the last operation, compared with 71.4% in group 2 (p=0.019). All patients were supported with antibiotics. In group 1, three patients died from septic multiorgan failure. Two patients in group 1 and one patient in group 2 received a Girdlestone operation.


CONCLUSIONS
These results suggest that aggressive surgical treatment with soft tissue revision, lavage, and implantation of an acetabular component in combination with antibiotics is a useful technique for treating early-onset infection.
Wick
M
M
Abteilung für Chirurgie, Standort Eggenfelden, Rottal-Inn-Krankenhäuser, Simonsöder Allee 20, 84307 Eggenfelden. marcwick@web.de
Maul
I
I
Muhr
G
G
D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D003646:Debridement / Q000379:methods*; D003661:Decision Support Techniques; D005260:Female; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D008297:Male; D011182:Postoperative Care / Q000379:methods; D016459:Prosthesis-Related Infections / Q000209:etiology* / Q000628:therapy*; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D007507:Therapeutic Irrigation / Q000379:methods*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents