title: Infectiological, functional, and radiographic outcome after revision for prosthetic hip infection according to a strict algorithm.
abstract: OBJECTIVE
  Successful treatment of prosthetic hip joint infection (PI) means elimination of infection and restored hip function. However, functional outcome is rarely studied. We analyzed the outcome of the strict use of a treatment algorithm for PI.
  
  
  METHODS
  The study groups included 22 hips with 1-stage exchange for PI (group 1), 22 matched hips revised for aseptic loosening (controls), and 50 hips with 2-stage exchange (group 2). Relapse of infection, Harris hip score (HHS), limping, use of crutches, reoperations, complications, and radiographic changes were compared between the groups.
  
  
  RESULTS
  There was 1 relapse of infection, which occurred in group 2. In group 1, the mean HHS was 84; 4 of 19 patients were limping and 2 required 2 crutches, which was similar to the control results. In group 2, scores were lower and complication rates higher. The use of a Burch-Schneider ring and the presence of a deficient trochanter impaired function. There were no differences in radiographic outcome between the groups.
  
  
  CONCLUSIONS
  With the algorithm used, infection can be cured with high reliability. With a 1-stage procedure, mobility is maintained. After 2-stage procedures, function was impaired due to there being more previous surgery and more serious infection.
authors.affiliation: Department of Orthopaedics, Sint Maartenskliniek, Nijmegen, the Netherlands.
authors.forename: F Harald R
authors.initials: FH
authors.lastname: De Man
authors.forename: Parham
authors.initials: P
authors.lastname: Sendi
authors.forename: Werner
authors.initials: W
authors.lastname: Zimmerli
authors.forename: Thomas B
authors.initials: TB
authors.lastname: Maurer
authors.forename: Peter E
authors.initials: PE
authors.lastname: Ochsner
authors.forename: Thomas
authors.initials: T
authors.lastname: Ilchmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006621:Hip Joint / Q000473:pathology; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D020127:Recovery of Function; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome