Hip Pelvis.  2014 Dec;26(4):227-234. 10.5371/hp.2014.26.4.227.

Efficacy of Debridement for Early Periprosthetic Joint Infection after Hip Arthroplasty

• Kim JH
• Chun SK
• Yoon YC
• Lakhotia D
• Shon WY

• KMID: 1907698
• DOI: http://doi.org/10.5371/hp.2014.26.4.227

Abstract

PURPOSE
In early prosthetic joint infection after hip arthroplasty, debridement with prosthesis retention may be performed for implant salvage, but the reported success rates are highly variable. Hence we reviewed the outcome of radical debridement and retention of prosthesis using established diagnostic criteria and surgical procedures in relation to significant variables including clinical characteristics, pathogenicity, and antibiotic treatment.
MATERIALS AND METHODS
We retrospectively reviewed 20 patients (11 men and 9 women) with early prosthetic joint infection after unilateral hip arthroplasty, treated by radical debridement with retention of prosthesis from January 2000 to May 2011. Average follow-up period was 55 months (12-178 months). The outcome was evaluated and analyzed based on recurrence of infection and clinical (Harris hip score) and radiological criteria.
RESULTS
Pathogens were isolated from 11 hips (methicillin-resistant Staphylococcus aureus [MRSA] in three, methicillin-resistant Staphylococcus epidermidis [MRSE] in two, methicillin-sensitive Staphylococcus aureus [MSSA] in one, Acinetobacter baumannii in two, Enterococcus faecalis in two patients, and Enterococcus, Citrobacter species in one). The mean duration of antibiotic administration was 43.5 days. Recurrence of infection was not observed in any case. Average Harris hip score was 91 points at the last follow-up. Revision surgery was not required for any reason including implant failure. Dislocation occurred in two hips after debridement and was treated conservatively.
CONCLUSION
Radical debridement with prosthesis retention is an effective procedure for early prosthetic joint infection after hip arthroplasty in carefully selected patients and with early diagnosis.

Keyword

Hip arthroplasty; Prosthetic infection; Debridement

MeSH Terms

Acinetobacter baumannii
Arthroplasty*
Citrobacter
Debridement*
Dislocations
Early Diagnosis
Enterococcus
Enterococcus faecalis
Follow-Up Studies
Hip*
Humans
Joints*
Male
Methicillin Resistance
Prostheses and Implants
Prosthesis Retention
Recurrence
Retrospective Studies
Staphylococcus aureus
Staphylococcus epidermidis
Virulence

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