Abstract
Treatment for an infected Total Hip replacement (THR) remains controversial with two stage revision surgery traditionally recommended. We describe a series of one stage revisions performed in a District General Hospital to help inform other surgeons and help treatment decisions.
8 patients with a bacteriologically proven infection in their hip underwent single stage revision THR. Cemented Exeter prostheses were used with additional antibiotics added to the cement mixture prior to implantation.
Follow-up ranged from 6 to 36 months (average 16.6 months) and there were no re-infections. No radiological changes consistent with re-infection were noted throughout patient follow-up. One patient suffered a periprosthetic fracture (thought to be secondary to myeloma) 3 months post-surgery and underwent further revision surgery. Post-operative antibiotics were given for a minimum of 6 weeks with 2 patients having a 3 month supply after Microbiology advice.
Single stage revision THR surgery is a viable and useful option for treatment of infected THR's. Re-infection rates are low. Avoiding the traditional second stage surgery is beneficial to both patients and the NHS trust in terms of health and cost outcomes. We will continue to undertake single stage revisions in this trust and advocate its use by other surgeons.
