Skip to main content

Abstract

Infections after total hip replacements are serious complications. They can be triggered either exogenously (intra- or perioperatively) or endogenously (haematogenously). In our own patient population, the infection rate was 0.82% in 1098 primary prostheses and 1.16% in 330 revisions. Considering just the predominantly exogenous infections, which almost always manifested themselves during the first 2 years, the respective infection rates were 0.4% and 0.35%. We distinguish between three types depending on the interval between operation and the manifestation of the infection:

  • Early infection: manifestation up to the end of the 3rd month

  • Delayed infection (mostly low-grade infection): from the 4th month up to 2 years after operation

  • Late infection: from the 3rd year after operation

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Berbari EF, Haussen AD, Duffy MC, Steckelberg JM, Ilstrup DM, Harmsen WS, Osmon DR (1998) Risk factors for prosthetic joint infection: case control study. Clin Infect Dis 27: 1247–1254

    Article  PubMed  CAS  Google Scholar 

  2. Brunazzi M, Mcharo C, Ochsner PE (1996) Hüfttotalprothesenwechsel — was erwartet den Patienten? Schweiz Med Wochenschr 126: 2013–2020

    PubMed  CAS  Google Scholar 

  3. Cheung A, Lachiewicz P, Renner J (1997) The role of aspiration and contrast-enhanced arthrography in evaluating the uncemented hip arthroplasty. AJR 168: 1305–1309

    PubMed  CAS  Google Scholar 

  4. Corstens FHM, Meer JWM van der (1999) Nuclear medicine’s role in infection and inflammation. Lancet 354: 765–770

    Article  PubMed  CAS  Google Scholar 

  5. Deacon JM, Pagliaro AJ, Zelicof SB, Horowitz HW (1998) Prophylactic use of antibiotics for procedures after total joint replacement. J Bone Joint Surg 78 (A): 1755–1770

    Google Scholar 

  6. Elke R, Zimmerh W, Morscher E (1997) Das infizierte Implantat und die septische Lockerung. In: Die Hüfte. Enke, Stuttgart, S 274–283

    Google Scholar 

  7. Engelbrecht E, Siegel A, Kappus M (1995) Totale Hüftendoprothese nach Resektions-arthroplastik. Orthopäde 24: 344–352

    PubMed  CAS  Google Scholar 

  8. Fitzgerald R (1995) Diagnosis and management of the infected hip prostheses. Orthopedics 18: 833–835

    PubMed  Google Scholar 

  9. Hauser R, Berchtold W, Schreiber A (1996) Incidence of deep sepsis in uncemented total hip arthroplasty using clean air facility as a function of antibiotic prophylaxis. Bull Hosp Jt Dis 54: 175–179

    PubMed  CAS  Google Scholar 

  10. Hunger T, Gösele A, Ochsner PE (1993) Implantierbares Venenkathetersystem zur ambulanten Langzeit-Antibiotikatherapie bei chronischer Osteomyelitis. Hefte Unfallchir 230: 1032–1035

    Google Scholar 

  11. Lehman CR, Ries MD, Paiement GD, Davidson AB (2001) Infection after total joint arthroplasty in patients with human immunodeficiency virus or intraveneous drug use. J Arthroplasty 16: 330–335

    Article  PubMed  CAS  Google Scholar 

  12. Liebermann J, Callaway G, Salvati E, Pellicci P, Brause B (1994) Treatment of the infected total hip arthroplasty with a two-stage reimplantation protocol. Clin Orthop 301: 205–212

    Google Scholar 

  13. Morscher E, Herzog R, Babst R, Zimmerh W (1995) Management of infected hip arthroplasty. Orthop Int 3: 343–351

    Google Scholar 

  14. Morscher E, Babst R, Jenny H (1990) Treatment of infected joint arthroplasty. Int Orthop 14: 161–165, 18: 833-835

    Article  PubMed  CAS  Google Scholar 

  15. Pfister A, Ochsner PE (1993) Erfahrungen mit geschlossenen Spül-Saug-Drainagen und gleichzeitiger Anwendung eines Antiseptikums. Unfallchirurg 96: 332–340

    PubMed  CAS  Google Scholar 

  16. Ochsner PE, Brunazzi M, Picard C (1995) Rettungseingriffe bei chronischem Infekt nach Hüfttotalprothesen. Orthopäde 24: 353–359

    PubMed  CAS  Google Scholar 

  17. Ochsner PE, Hauser R, Lotz M (1987) Diagnostik und Therapie der Skelettinfektionen aus orthopädischer Sicht. Praxis 76: 532–542

    PubMed  CAS  Google Scholar 

  18. Salvati E (1994) Diagnosis and management of the infected hip. Orthopedics 17: 811–814

    PubMed  CAS  Google Scholar 

  19. Schafroth MU, Ochsner PE (1999) Does Staphylococcus aureus infection worsen the prognosis for treatment of infected total hip replacement? Eur J Orthop Surg Traumatol 9: 241–244

    Article  Google Scholar 

  20. Schafroth MU, Zimmerh W, Ochsner PE (1999) Das infizierte künstliche Hüftgelenk: Möglichkeiten, Verlauf und Resultate der Behandlung. Praxis 88: 2101–2105

    PubMed  CAS  Google Scholar 

  21. Smith TL, Pearson ML, Wilcox KR, Cruz C, Lancaster MV et al. (1999) Emergence of vancomycin resistance in Staphylococcus aureus. N Engl J Med 340: 493–501

    Article  PubMed  CAS  Google Scholar 

  22. Taylor T, Beggs I (1995) Fine needle aspiration in infected hip replacements. Clin Radiol 50: 149–152

    Article  PubMed  CAS  Google Scholar 

  23. Tigges S, Stiles R, Roberson J (1994) Appearance of septic hip prostheses on plain radiographs. AJR 163: 377–380

    PubMed  CAS  Google Scholar 

  24. Tunney MM, Patrick S, Curran MD, Ramage G, Hanna D, Nixon JR, Gorman SP, Davis RI, Anderson N (1999) Detection of prosthetic hip infection at revision arthroplasty by immunofluorescence microscopy and PGR amplification of the bacterial 16S rRNA gene. J Clin Microbiol 37: 3281–3290

    PubMed  CAS  Google Scholar 

  25. Widmer AF, Colombo VE, Gächter A, Thiel G, Zimmerli W (1990) Salmonella infection in total hip replacement: tests to predict the outcome of antimicrobial therapy. Scand J Infect Dis 22: 611–618

    Article  PubMed  CAS  Google Scholar 

  26. Wilde A (1994) Management of infected knee and hip prosthesis. Rheumatology 6: 172–176

    CAS  Google Scholar 

  27. Willenegger H, Roth B (1986) Behandlungstaktik und Spätergebnisse bei Frühinfekt nach Osteosynthese. Unfallchirurgie 12: 241–246

    Article  PubMed  CAS  Google Scholar 

  28. Willenegger H, Roth B, Ochsner PE (1995) The return of local antiseptics in surgery. Injury 26: Suppl 1

    Google Scholar 

  29. Wroblewski B, Siney P (1993) Charnley low-friction arthroplasty of the hip. Long-term results. Clin Orthop 292: 191–201

    PubMed  Google Scholar 

  30. Younger A, Duncan C, Masri B, McGraw R (1997) The outcome of two-stage arthroplasty using a custommade interval spacer to treat the infected hip. J Arthroplasty 12: 615–623

    Article  PubMed  CAS  Google Scholar 

  31. Zimmerh W (1984) Hämatogener Protheseninfekt beim Menschen und im Tiermodell. Schweiz Med Wochenschr 114: 1756–1757

    Google Scholar 

  32. Zimmerli W, Zak 0, Vosbeck K (1985) Experimental hematogenous infection of subcutaneously implanted foreign bodies. Scand J Infect Dis 17: 303–310

    PubMed  CAS  Google Scholar 

  33. Zimmerli W, Frei R, Widmer AF, Rajacic Z (1994) Microbiological tests to predict treatment outcome in experimental device-related infections due to Staphylococcus aureus. J Antimicrob Chemother 33: 959–967

    Article  PubMed  CAS  Google Scholar 

  34. Zimmerh W, Widmer A, Blatter M, Frei R, Ochsner PE (1998) Role of rifampicin for treatment of orthopedic implant-related staphylococcal infections. JAMA 279: 1537–1541

    Article  Google Scholar 

  35. Zimmerh W (1999) Prosthetic device infection. In: Root RK et al. (eds) Clinical infectious diseases: a practical approach. Oxford Univ Press, London, pp 801–808

    Google Scholar 

  36. Zimmerli W (2000) Antibiotic prophylaxis. In: Rüedi TP et al. (eds) AO principles of fracture management. Thieme, Stuttgart, pp 699–707

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2003 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Schafroth, M., Zimmerli, W., Brunazzi, M., Ochsner, P.E. (2003). Infections. In: Ochsner, P.E. (eds) Total Hip Replacement. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-55679-1_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-55679-1_5

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-62868-9

  • Online ISBN: 978-3-642-55679-1

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics