title: Encouraging outcomes of staged, uncemented arthroplasty with short-term antibiotic therapy for treatment of recalcitrant septic arthritis of the native hip.
abstract: BACKGROUND
  Septic arthritis in native hip joints is a rare but serious condition in adult patients. Prompt aggressive surgical and medical treatment is a challenge, and the outcomes after delayed management can be devastating. This article reports the findings of treatment of recalcitrant cases using a standardized protocol.
  
  
  METHODS
  Fourteen consecutive patients (15 hips) were treated with two-stage total hip arthroplasty (THA) for septic arthritis of the hip joint over a 6-year period. All patients underwent resection arthroplasty and implantation of an antibiotic-loaded articulating spacer in the first stage, short-term systemic antibiotic therapy during the interim period, and subsequent THA without bone cement in the second stage.
  
  
  RESULTS
  One patient required additional debridement and spacer reinsertion before THA. The mean interim period was 12.9 weeks (range, 6-31 weeks). After an average follow-up period of 42.5 months (range, 25-72 months) after THA, there was no evidence of recurrent infection or loosening of the prostheses in any patient. The average Merle D'Aubigne and Postel hip score improved from 9.3 (range, 5-15) to 13.5 (range, 12-16) between stages and to 16.7 (range, 15-18) at the latest follow-up.
  
  
  CONCLUSIONS
  Two-stage uncemented THA is a reliable treatment option for adult patients with recalcitrant septic hips. If an antibiotic-loaded interim spacer is used, routine, prolonged systemic antibiotic therapy may not be necessary.
authors.affiliation: Department of Orthopedics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Tsan-Wen
authors.initials: TW
authors.lastname: Huang
authors.forename: Kuo-Chin
authors.initials: KC
authors.lastname: Huang
authors.forename: Po-Cheng
authors.initials: PC
authors.lastname: Lee
authors.forename: Ching-Lung
authors.initials: CL
authors.lastname: Tai
authors.forename: Pang-Hsin
authors.initials: PH
authors.lastname: Hsieh
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001170:Arthritis, Infectious / Q000188:drug therapy* / Q000601:surgery*; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000188:drug therapy* / Q000601:surgery*; D016459:Prosthesis-Related Infections / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents