We analysed the clinical outcome of infected hip and knee replacements treated in Dunedin over a 10 year period.

Using the departmental audit data base all infected arthroplasties treated between 1990 and 2000 and the clinical notes reviewed.

Fifty-three hips and 20 knees were identified. 69% of patients had debridement and antibiotics as the primary treatment. In terms of prosthesis retention 41% of patients had retained the original prosthesis, 30% had implants in place following revision and 29% had a resection arthroplasty or arthrodesis. Retention of the original prosthesis was significantly higher in early as compared to late infections and knees did better than hips. The most common organisms identified were staphylococci (47%) and streptococci (29%). We did not see any difference in outcome of streptococcal infections.

The treatment of infected arthroplasties remains controversial. We propose management guidelines based on outcomes of a series of 73 cases.