Diagnosis and treatment of peri-prosthetic infections in total hip replacement.
Total hip replacement (THR) has a very good clinical outcome. Peri-prosthetic infection is a severe complication with infection rates 0.5-2% after primary THR. Systematic reviews and meta-analyses published in recent years have allowed drafting of evidence based guidelines for diagnosis and treatment of peri-prosthetic infection after THR. If an implant related infection is suspected, a complex standardised procedure should be carried out. The most commonly cultured microorganisms causing peri-prosthetic infections are coagulase-negative staphylococci and S.aureus followed by mixed flora, streptococci, gram-negative bacilli, enterococci and anaerobes. Different treatment strategies can be applied regarding virulence of a specific pathogen, mechanical stability of the implant and patient's condition. Treatment options always include antibiotic therapy with/without surgical procedures like debridement, one/two stage approach or resection arthroplasty.
St. Catherine Specialty Hospital, Zabok, Croatia. ortohud@gmail.com
Damir
D
Hudetz
Eduard
E
Rod
Andrej
A
Radić
Alan
A
Ivković
D019644:Arthroplasty, Replacement, Hip; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000382:microbiology / Q000517:prevention & control / Q000628:therapy*