Risk factors associated with acute hip prosthetic joint infections and outcome of treatment with a rifampinbased regimen

Background and purpose Acute prosthetic infection is a serious problem. We report factors related to the incidence of acute infection and results of combined joint debridement and prolonged rifampicin-based antibiotic therapy.

Patients and methods Between 1998 and 2004, 14 acute infections occurred after 819 primary hip arthroplasties. The association between patient-related and surgical factors and the risk of infection were analyzed. Infections were treated with multiple joint lavage, debridement, 2 weeks of antibiotic therapy, and then oral antibiotics for a minimum of 6 months.

Results There was a correlation between having a body mass index (BMI) of ≥ 30, and also more than 2 co-morbidities, and an increased risk of infection. Diabetes was a potential risk factor. Following our regime of treatment, 11 of 14 patients retained their prosthesis. 2 of 3 who required resection arthroplasty underwent successful staged revision, while the third patient had no further surgery because of being deemed unfit.

Interpretation Primary joint replacement was salvaged in 11 of 14 patients. When successful re-implanta-tion was included, 13 of 14 patients had a mobile prosthetic joint without further infection.