Abstract
Introduction and Aims: The standard treatment for an infected total hip replacement involves removal of all foreign material and re-implantation in either one or two stages with antibiotic cement. This study has investigated the use of cementless reconstruction in infected hip arthroplasties to determine if there is a difference in the re-infection rate.
Method: Thirteen patients (three females and 10 males) with an average age of 67 have been followed-up prospectively after revision hip surgery for infection. Removal of the prosthesis was followed by six weeks intravenous antibiotics and in some cases a period of oral therapy. Reconstruction was undertaken at a median of four months post Girdlestone’s arthroplasty, with the exception of a one-stage exchange for medical reasons. Cementless titanium femoral components were used in all revisions and titanium acetabular components where applicable. Allograft and cage reconstruction were employed for major pelvic defects.
Results: Patients have been followed-up for an average of 58 months (range 12–96 months), with no loss to follow-up. Bacteria were cultured from eleven (11) of the thirteen (13) patients and the other two were clinically septic. Bacteria cultured included MRSA, Staph. Aureus, E.Coli and Strep. Faecalis. All prostheses remain in situ with improvement in both Charnley and Oxford hip scores. No recurrence of infection has been documented clinically or radiologically and no component is loose.
Conclusion: Debate still exists about the merits of one vs. two-stage reconstruction for infected hip arthroplasty. This series with mid-term follow-up demonstrates that cementless reconstruction for infected hip arthroplasty is successful in providing an infection-free stable revision.
These abstracts were prepared by Editorial Secretary, George Sikorski. Correspondence should be addressed to Australian Orthopaedic Association, Ground Floor, The William Bland Centre, 229 Macquarie Street, Sydney, NSW 2000, Australia.
At least one of the authors is receiving or has received material benefits or support from a commercial source.
