Abstract
Introduction
Native hip joint infection can result in hip arthrosis as a complication requiring the need for subsequent arthroplasty. There is little evidence to support single or staged THA. We present the results of patients who have undergone total hip arthroplasty (THA) following hip joint sepsis in our institution.
Methods
Patients receiving a THA following previous hip joint sepsis between 2003 and 2015 were identified from the operative records database. Further clinical information was collected from the medical records, including timing of infection and surgery, as well as culture results. Functional outcome (Oxford Hip Score, OHS) and patient satisfaction scores (PSS) were recorded.
Results
There were 21 males and 12 females with a mean age of 54 (21–82) at a mean follow up of 6.4 years (2–12) following definitive implantation. Thirteen patients underwent a single stage THA and 20 patients had a 2 stage procedure, two of whom required a repeat 1st stage prior to implantation. The mean time from native hip infection to operation was 17.2 years (3–59). At implantation, positive cultures were present in 19 cases, 13 of which were S. aureus. Two patients required revision due to a periprosthetic fracture and one patient required debridement, antibiotics and implant retention (DAIR). Therefore, the implant survivorship was 94% and infection rate was 3% at 6.4 years.
Discussion
Both single and staged arthroplasty provide good results in patients who have developed septic arthritis. THA as a single stage was performed predominately in patients with a long remission between their initial infection and presentation. Positive culture at implantation does not confer a bad outcome as long as a thorough debridement is performed as routine in this patient group. Patient comorbidities are an important factor as both cases requiring reoperation were in IV drug users with Hepatitis C.
