Abstract
Aims: To present a two-stage treatment protocol for a septic hip replacement that addresses infection control while restoring acetabular and femoral bone stock utilizing impaction grafting techniques with Vancomycin loaded allografts. Methods: We report 30 consecutive cases in 29 patients with a deep infected hip arthroplasty treated by excision of implants, meticulous debridement, parenteral antibiotic therapy and second-stage reconstruction with Vancomycin-supplemented impacted bone allografts implanting a Charnley prosthesis. Results: The mean follow-up was 32.4 months (24 to 60). Infection control was obtained in 29 cases (97%) without evidence of progressive radiolucent lines, demarcation or graft resorption. One case presented an overinfection 10 months after reimplantation due to a different pathogen. Associated postoperative complications were 1 traumatic periprosthetic fracture at 14 months, single dislocation in 2 cases and 4 greater trochanter migrations. Conclusions: Vancomycin-supplemented allografts biologically restored bone stock and provided sound þxation without increasing the recurrence of infection in most of the patients. Observing these results we consider that an infected hip arthroplasty can be successfully treated following this suggested protocol.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
