Abstract
Purpose:
The purpose of this study was to evaluate the results of two stage reconstruction for infected arthroplasty of hip joint and to know the risk factor for failures.
Patients and Methods:
From May 2004 to September 2011, 104 consecutive patients (105 hips) who underwent two stage reconstruction for the infected arthroplasty of hip joint were retrospectively evaluated. There were 60 hips with primary THA infection (Acute infection 22, Delayed infection 38), 4 hips with revision THA infection (Acute infection 1, Delayed infection 3), 20 hips with primary hemiarthroplasty infection (Acute infection 14, Delayed infection 6) and 24 hips with acute pyogenic coxitis. We evaluated the number of surgeries before two-stage reconstruction and also analysed the cultured pathogens. Mean follow duration after 2nd stage revision THA was 1.80 ± 1.76 years and average age at the time of 1st stage surgery (Debridement and PROSTALAC insertion) was 62.8 ± 14.3 years.
Results:
Among 104 hips, there were 19 hips (18.3%) with uncontrolled infection after 1st stage surgery. In the other 85 hips, there were 8 hips (9.41%) with re-infection after 2nd stage revision THA. Among 104 hips, identification of the pathogens was possible in 83 hips.(MRSA 22 hips, MRSE-4 hips, MSSA-23 hips, Pseudomonas-3 hips, Tuberculous-2 hips, Enterococcus-7 hips, Candida-3 hips).
The most important risk factors for failure were the number of surgeries prior to two stage reconstruction, revision THA and age. Comorbidity, BMI, Sex showed no significant increase for re-infection. There was no difference after primary THA and hemiarthroplasty.
Conclusions:
Two stage reconstruction for infected arthroplasty of hip joint was a useful method for eradication of infection. In the treatment of infected hip arthroplasty, failed simple debridement can be a risk factor of re-infection after revision THA.
