title: One-stage revision of an infected cementless total hip replacement.
abstract: A two-year-old, 44 kg dog with a right Helica cementless total hip replacement (THR) was radiographically diagnosed with implant loosening eight months after the index total hip replacement procedure. Subsequent synoviocentesis and synovial fluid culture revealed a methicillin-resistant coagulase-negative Staphylococcus spp infection of the right THR. A one-stage revision using a hybrid BFX cementless acetabular cup and CFX cemented femoral stem was performed. Vancomycin and micro-silver antimicrobial powder impregnated cement were used in the revision. At re-evaluation 27 months following the revision procedure, the patient did not exhibit any signs of lameness. Radiographic images confirmed stable implants, with bone ingrowth into the cup and no signs of implant loosening. Our report demonstrates the success of a one-stage THR revision when faced with a multi-drug resistant periprosthetic infection, when combined with the use of micro-silver antimicrobial powder and culture-based antibiotic impregnated cement therapy.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Ficklin
authors.forename: Michael P
authors.initials: MP
authors.lastname: Kowaleski
authors.forename: Kevin A R
authors.initials: KA
authors.lastname: Kunkel
authors.affiliation: Dr. Jonathan T. Suber, VCA Animal Specialty Center of South Carolina, 3912 Fernandina Road, Columbia, SC 29210, United States, Phone: +1 803 798 0803, Fax: +1 803 798 7916, E-mail: jonathan.suber@vca.com.
authors.forename: Jonathan T
authors.initials: JT
authors.lastname: Suber
mesh_terms: D000818:Animals; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000662:veterinary*; D001843:Bone Cements; D004283:Dog Diseases / Q000382:microbiology* / Q000601:surgery; D004285:Dogs; D005260:Female; D011183:Postoperative Complications / Q000382:microbiology / Q000662:veterinary*; D011475:Prosthesis Failure / Q000209:etiology; D016459:Prosthesis-Related Infections / Q000150:complications / Q000601:surgery; D012086:Reoperation / Q000662:veterinary; D013203:Staphylococcal Infections / Q000150:complications / Q000382:microbiology / Q000662:veterinary*
chemical_list: D001843:Bone Cements
keywords: Silver; canine; dog; resistant infection; single stage revision; total hip replacement