Single-Stage Revision for Periprosthetic Hip Infection Using Antibiotic Loaded Impaction Graft
Ebied, A. M., Elseedy, A. I., & Gamal, O. (2016).Hip
Background
Staged revision for periprosthetic infection of the hip is an accepted and widely used technique by many surgeons. However, single-stage exchange of the hip prosthesis remains an attractive option to others because of the advantages of reduced morbidity, shorter treatment time and hospital stay in addition to the reduced cost of treatment.
Hypothesis
Single-stage revision for periprosthetic hip infection can achieve excellent results if a specific protocol for patients’ selection and management is followed.
Methods
52 patients with evidence of periprosthetic infection had preoperative aspiration of the affected hip. The infecting organisms were identified in 33/52 and single-stage revision was performed. The remaining 19 patients had a 2-stage exchange arthroplasty. Patients in the single-stage revision protocol had antibiotic loaded morsellized bone graft, a cemented cup and a long cementless stem.
Results
At an average follow up of 6 (range 4-8) years postoperatively, only 1 case of persistent infection was found in the single-stage group – a 97% rate of eradicating infection was achieved.
Discussion
Single-stage exchange achieves excellent success rate in patients with periprosthetic infection when a specific protocol for patient selection and management is followed.
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