title: Early prosthetic hip joint infection treated with debridement, prosthesis retention and biofilm-active antibiotics: functional outcomes, quality of life and complications.
abstract: BACKGROUND
  Patients treated for early prosthetic joint infection (PJI) with surgical debridement, prosthesis retention and biofilm-active antibiotics, such as rifampicin or fluoroquinolones have a rate of successful infection eradication that is similar to patients treated with the traditional approach of prosthesis exchange. It is therefore important to consider other outcomes after PJI treatment that may influence management decisions, such as function, quality of life (QOL) and treatment-associated complications.
  
  
  OBJECTIVE
  To describe rates of successful treatment for patients with PJI undergoing surgical debridement, prosthesis retention and biofilm-active antibiotics and compare their functional outcomes, QOL and complication rates to patients without PJI.
  
  
  METHODS
  Nineteen patients treated for PJI after hip arthroplasty with debridement, prosthesis retention and biofilm-active antibiotics were matched to 76 controls who underwent hip arthroplasty with no infection.
  
  
  RESULTS
  Cumulative survival free from treatment failure at 2 years was 88% (95% confidence interval, 59-97%). PJI cases had significant improvement from pre-arthroplasty to 12-months post-arthroplasty in function according to Harris Hip Score and QOL according to the 12-item Short Form Health Survey Physical Component Summary. There was no significant difference in the improvement between controls and cases. PJI was not a risk factor for poor function or QOL. Medical complications occurred more frequently in cases (6/19 (32%)) than controls (9/76 (12%); P = 0.04), with this difference being accounted for by drug reactions. Surgical complications were the same in the two groups.
  
  
  CONCLUSIONS
  Treatment of PJI with debridement, prosthesis retention and biofilm-active antibiotics is successful, well tolerated and results in significant improvements in function and QOL, which are similar to patients without PJI.
authors: Department of Infectious Diseases, St Vincent's Hospital, Melbourne, Victoria, Australia. craig.aboltins@svhm.org.au
authors: C
authors: C
authors: Aboltins
authors: M M
authors: MM
authors: Dowsey
authors: T
authors: T
authors: Peel
authors: W K
authors: WK
authors: Lim
authors: S
authors: S
authors: Parikh
authors: P
authors: P
authors: Stanley
authors: P F
authors: PF
authors: Choong
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D018441:Biofilms / Q000187:drug effects; D016022:Case-Control Studies; D003646:Debridement / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D060489:Prosthesis Retention / Q000379:methods*; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D011788:Quality of Life; D020127:Recovery of Function / Q000502:physiology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: adverse effect; debridement; prosthetic-related infection; quality of life; rifampicin