Introduction and purpose: Two-stage reimplantation of a hip replacement is the treatment of choice for deep periprosthetic infections. The purpose of this study is to analyse the survival of the femoral component in two-stage hip replacement reimplantations and compare the results of cemented and cementless components.

Materials and methods: Between 1988 and 1998 our hospital carried out 169 two-stage reimplantations for treatment of first episodes of deep infection. The femoral component was cemented in 121 cases and cementless in 48. All patients were followed up clinically and radiologically for at least five years.

Results: The two-stage revision was associated with a significant clinical improvement. The reinfection rate was 9% (16/169), of which 11 patients underwent revision surgery and five received chronic suppressive antibiotic treatment. Eight patients required revision due to aseptic loosening and two for periprosthetic fracture. With the numbers available, fixation with or without cement showed no significant differences.

Conclusions: The two-stage revision of an infected hip prosthesis resolved the infection in 91% of the cases. An additional 5% required revision due to aseptic loosening. The surgical outcomes seem to be independent of the femoral component fixation (cemented or cementless).

Introduction and Objectives: The increase in hip replacement surgery in recent years as a consequence of the aging population and a greater demand placed on joints by our current lifestyle has caused an increase in related complications. The rate of intraoperative periprosthetic fractures is between 0.8 and 2.3%, and postoperative fracture rates reach 0.1% in some studies. This type of fracture is usually complex, and treatment is almost always quite difficult.

Materials and Methods: This study concentrates on peri-prosthetic hip fracture as a postoperative complication examining cases treated during the last 5 years. We have included cases of cemented and cementless partial and total arthroplasty. In this study, we did not include intra-operative fractures (secondary to surgical manipulation, as a result of reaming, cementing, or impaction of prosthetic components) because an irregular clinical history was associated with such cases, only reflecting those which required some type of synthesis, particularly cer-clage. The Johanson scale and the AAOS classification were used to classify fractures.

Results: Of 30 periprosthetic fractures recorded during the study period, 11 patients (36.7%) were males and 63.3% were female. Of fractures of the femoral diaphysis, more than half were Johanson Type II. Only one case involved the acetabulum. Nearly 17% required revision of some prosthetic component, and about one-third could be resolved orthopaedically. Of cases treated surgically, most complications were related to the surgical wound.

Discussion and Conclusions: The type of treatment used depends on various factors, such as type of fracture and fracture line, patient age, prosthetic loosening, etc. Individualised treatment is therefore the standard. We have observed no abnormalities in bone healing. Although this type of fracture is fortunately rare, we consider good preoperative planning and a thorough postoperative follow-up to be very important for the correct resolution of this difficult problem.