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Acetabular Bone Defect in Infected Total Hip Arthroplasty

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Acetabular Revision Surgery in Major Bone Defects

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Abstract

Periprosthetic joint infection is the most severe complication in terms of mortality, morbidity and functional disability. Diagnosis is challenging and it is a frequent cause of repeated surgeries. Treatment depends on the general status of the patient, the bone status (stock) receiving the new implant, and the microbiology analysis. Diagnosis of infection include the type of pain; some signs as drainage and dehiscence of the wound; blood analysis; imaging assessment; articular aspiration, biopsy and cultures; sonication of retrieval implants; pathology and cultures of intraoperative samples. International Consensus has postulated different infection criteria. Once the infection is diagnosed and the surgery is decided, a multidisciplinary approach with the Microbiology and Infectious Disease Department is recommended to properly manage the antibiotherapy. The reconstruction of the acetabular bone defect in the infected hip include filling with antibiotic-loaded cement only for small cavitary defects and low-demand patients. Cementless implants are more widely used for small or moderate acetabular bone defects. The most serious cases with large bone acetabular defects will be managed with similar techniques in infected cases and aseptic cases, such as impacting bone grafting technique associated with a cemented cup, porous augments or metallic rings.

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  1. Orthopaedic Surgery Department, Hospital Universitario La Princesa, Madrid, Spain

    Jose Cordero-Ampuero

  2. Orthopaedic Surgery Department, Hospital Universitario La Paz-IdiPaz, Madrid, Spain

    Eduardo García-Rey

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    Eduardo García-Rey

  2. Orthopaedic Surgery Department, Hospital Universitario La Paz-IdiPaz, Madrid, Spain

    Eduardo García-Cimbrelo

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Cordero-Ampuero, J., García-Rey, E. (2019). Acetabular Bone Defect in Infected Total Hip Arthroplasty. In: García-Rey, E., García-Cimbrelo, E. (eds) Acetabular Revision Surgery in Major Bone Defects. Springer, Cham. https://doi.org/10.1007/978-3-319-98596-1_12

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