Debridement, antibiotics, and implant retention (DAIR) for acute prosthetic hip infection is a popular low morbidity option despite less than optimal success rates. We theorized that the delay between DAIR and explantation in failed cases may complicate eradication due to biofilm maturation and entrenchment of bacteria in periprosthetic bone. We ask, what are the results of two-stage reimplantation after a failed DAIR versus an initial two-stage procedure? 114 patients were treated with 2-stage exchange for periprosthetic hip infection. 65 were treated initially with a 2-stage exchange, while 49 underwent an antecedent DAIR prior to a 2-stage exchange. Patients were classified according to MSIS host criteria. Failure was defined as return to the OR for infection, a draining sinus, or systemic infection.Introduction
Methods
Four hundred and fifteen patients with cementless acetabular components of either a smooth threaded (130) or porous surfaced (285) variety were compared for clinical symptoms and radiographic signs of component loosening. At a mean 4.8 year follow-up none of the patients with porous acetabular components had signs of component instability. At a mean 3.9 year follow-up 27 (21%) of the patients with a smooth threaded acetabular component showed radiographic signs of instability and 33 (25%) had clinical symptoms. The disappointing short-term results with these threaded cups in our hands have prompted us to abandon their use in favour of the porous surfaced hemispherical cups.
