Abstract
Introduction
The goal of treating artificial joint infection is to relieve the infection quickly and re-establish joint function, but many patients have underlying diseases, and treatment is often made problematic by the diversity of the causative bacteria. In this study we assessed the factor that enabled revision arthroplasty in patients with infection after artificial hip arthroplasty, including bipolar hip arthroplasty, in our hospital.
Subjectives and Methods
The subjects were the 16 patients (16 hips) with infection after hip arthroplasty who were treated in our hospital during the past 10 years. There were 7 males and 9 females, and their mean age was 69.8 years. Primary total hip arthroplasty had been performed in 6 hips, revision hip arthroplasty in 8 hips, and bipolar hip arthroplasty in 2 hips. Infected implants were removed as soon as possible and delayed reimplantations with an interval antibiotic spacer were attempted in all patients. 9 hips were successful in reimplantation (reimplantation group) and 7 hips were impossible (No reimplantation group). In this study we investigated age, complications, body mass index (BMI), body temperature, pain, rate of resistant bacteria, number of hip surgery prior to infection and clinical manifestations compared to two groups.
Results
Age, rate of resistant bacteria, body temperature and number of surgery were not significantly different compared to two groups. In no reimplantation group BMI was significantly low. Also, local heat, redness and fistula as clinical manifestations had been observed in most no reimplantation hips. Conversely there were no associations with the presence or absence of swelling, tenderness and pain in initial consultation.
Discussion
Garvin et al. have reported a two-stage reimplantation success rate for infected artificial joints of 91%. However, our results comparatively showed lower successful rate. It is suggested that lower BMI, presence of local heat, redness and fistulation were risk factors for reimplantation. Especially, these clinical manifestations means that the infection widely invade to subcutaneous tissue. Therefore, we should performed debridement and antibiotic treatment more carefully.
