title: [Cementless two-staged total hip arthroplasty for chronic periprosthetic infection].
abstract: OBJECTIVE
  To determine the clinical outcomes of two-staged cementless revision arthroplasty for the treatment of deep periprosthetic infection after total hip arthroplasty.
  
  
  METHODS
  Twenty-three patients with deep periprosthetic infection treated with a standard protocol of two-staged cementless revision hip arthroplasty were enrolled in this study. There were 9 male patients and 14 female patients with an average age of 64 years (range, 52-78 years). In all cases, antibiotics-loaded cement spacers were implanted after removal of all the prosthetic components and thorough debridements had been done. All patients had a minimum of 2 weeks of intravenous antibiotics followed by 4 weeks of oral antibiotics after implant removal. After a mean interval of 6.7 months (3-28 months), revision arthroplasties were carried out with cementless femoral components followed by 2 weeks of intravenous antibiotics and 4 weeks of oral antibiotics.
  
  
  RESULTS
  The mean follow-up period was (4.3±3.5) years. There were 2 cases of recurrent infections in this study. Intraoperative periprosthetic fractures were observed in 3 patients. One patient had dislocation of the implanted spacer during the interval period and 2 patients had hip dislocation after reimplantation. Mild subsidence of femoral component occurred in 1 patient. There were no cases of loosening of femoral components and cementless acetabular components in patients without infection recurrence. The Harris hip score increased from a preoperative mean of 36±13 to 85±13 at 12 months after reimplantation.
  
  
  CONCLUSIONS
  Using cementless prostheses in two-staged revisions of hip periprosthetic infections can provide low rate of infection recurrence and good implant stability, but cautions must be taken when treating patients with infection caused by multidrug-resistant organisms.
authors.affiliation: Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200233, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Shen
authors.forename: Qiao-jie
authors.initials: QJ
authors.lastname: Wang
authors.forename: Xian-long
authors.initials: XL
authors.lastname: Zhang
authors.forename: Yao
authors.initials: Y
authors.lastname: Jiang
authors.forename: Qi
authors.initials: Q
authors.lastname: Wang
authors.forename: Yun-su
authors.initials: YS
authors.lastname: Chen
authors.forename: Jun-jie
authors.initials: JJ
authors.lastname: Shao
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000601:surgery*; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents