Summary
Sixty-two patients presented with an infected total hip arthroplasty. Their management depended on their general medical condition, the clinical signs of infection, the type of infection, the degree of fixation of the components and the available bone stock. Treatment consisted of one of the following: debridement and lavage without removing the prosthesis, one or two stage revision arthroplasty, or excision arthroplasty. There were 11 early and 51 late infections. The commonest bacterium isolated was Staphylococcus epidermidis (30%). Primary revision of the femoral component was slightly more successful with a cemented prosthesis than with an uncemented prosthesis. The overall success rates for cemented and uncemented femoral components were roughly comparable (91.5%:90%). We make various recommendations for the management of infected total hip arthroplasties based on our experience
Résumé
La stratégie du traitement des prothèses totales de hanche infectées est décrite à partir de 62 cas. Le procédé thérapeutique est décidé en tenant compte de l'état général et des signes cliniques de l'infection, du germe, de l'état de l'ancrage de la prothèse et de l'état du lit osseux:
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-soit la prothèse est laissée in situ,
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-soit la prothèse est changée en un ou deux temps,
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-soit on procède à une résection (type Girdlestone).
Nos patients ont présenté 11 fois des infections précoces et 51 fois des infections tardives. Le germe le plus fréquent était le staphylocoque epidermidis (30%). Le taux de réussite primaire des révisions avec implantation de tige cimentée est un peu meilleur que celui des révisions avec implantation d'une tige non cimentée. Le taux de réussite définitif est de 91,5% pour les tiges cimentées et de 90% pour les non cimentées. Nous basant sur cette étude, nous proposons des recommandations concernant le traitement des prothèses de hanches infectées.
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Morscher, E., Babst, R. & Jenny, H. Treatment of infected joint arthroplasty. International Orthopaedics 14, 161–165 (1990). https://doi.org/10.1007/BF00180122
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DOI: https://doi.org/10.1007/BF00180122