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Early prosthetic joint infections treated with debridement and implant retention: 38 primary hip arthroplasties prospectively recorded and followed for median 4 years.
Acta Orthop 2012; 83(3):227-32AO

Abstract

BACKGROUND AND PURPOSE

Debridement and retention of the prosthesis is often attempted to treat early prosthetic joint infection (PJI). However, previous studies have found inconsistent results, with success rates ranging from 21% to 100%, and little has been written in the literature about hip function. We have therefore analyzed the clinical and functional outcome of early PJIs treated with this procedure.

PATIENTS AND METHODS

38 patients with early PJI after primary hip arthroplasty who were treated with debridement and retention of the implant between 1998 and 2005 were studied prospectively, with a median follow-up time of 4 (0.8-10) years. Early infection was defined as that which occurred within 4 weeks of index arthroplasty. The primary outcome measure was infection control. Functional outcome was assessed with the Harris hip score.

RESULTS

27 of 38 patients were successfully treated, with no signs of infection or continued antibiotic treatment at the latest follow-up. Median Harris hip score was 86 (47-100) points. In 9 of the 11 patients for whom treatment failed, infection was successfully treated with 1-stage or 2-stage reimplantation or resection. Intraoperative cultures were positive in 36 hips, and the most frequently isolated organisms were Staphylococcus aureus and coagulase-negative staphylococci (CoNS). 15 infections were polymicrobial, and only 8 of them were successfully treated with debridement and retention of the implant.

INTERPRETATION

Our data suggest that debridement and retention of the prosthesis is a reasonable treatment option in early PJI after primary hip arthroplasty, with satisfactory functional results.

Authors+Show Affiliations

Department of Orthopaedics, Oslo University Hospital, Oslo, Norway. marianne.westberg@oslo-universitetssykehus.noNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22489892

Citation

Westberg, Marianne, et al. "Early Prosthetic Joint Infections Treated With Debridement and Implant Retention: 38 Primary Hip Arthroplasties Prospectively Recorded and Followed for Median 4 Years." Acta Orthopaedica, vol. 83, no. 3, 2012, pp. 227-32.
Westberg M, Grøgaard B, Snorrason F. Early prosthetic joint infections treated with debridement and implant retention: 38 primary hip arthroplasties prospectively recorded and followed for median 4 years. Acta Orthop. 2012;83(3):227-32.
Westberg, M., Grøgaard, B., & Snorrason, F. (2012). Early prosthetic joint infections treated with debridement and implant retention: 38 primary hip arthroplasties prospectively recorded and followed for median 4 years. Acta Orthopaedica, 83(3), pp. 227-32. doi:10.3109/17453674.2012.678801.
Westberg M, Grøgaard B, Snorrason F. Early Prosthetic Joint Infections Treated With Debridement and Implant Retention: 38 Primary Hip Arthroplasties Prospectively Recorded and Followed for Median 4 Years. Acta Orthop. 2012;83(3):227-32. PubMed PMID: 22489892.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early prosthetic joint infections treated with debridement and implant retention: 38 primary hip arthroplasties prospectively recorded and followed for median 4 years. AU - Westberg,Marianne, AU - Grøgaard,Bjarne, AU - Snorrason,Finnur, Y1 - 2012/04/11/ PY - 2012/4/12/entrez PY - 2012/4/12/pubmed PY - 2012/8/7/medline SP - 227 EP - 32 JF - Acta orthopaedica JO - Acta Orthop VL - 83 IS - 3 N2 - BACKGROUND AND PURPOSE: Debridement and retention of the prosthesis is often attempted to treat early prosthetic joint infection (PJI). However, previous studies have found inconsistent results, with success rates ranging from 21% to 100%, and little has been written in the literature about hip function. We have therefore analyzed the clinical and functional outcome of early PJIs treated with this procedure. PATIENTS AND METHODS: 38 patients with early PJI after primary hip arthroplasty who were treated with debridement and retention of the implant between 1998 and 2005 were studied prospectively, with a median follow-up time of 4 (0.8-10) years. Early infection was defined as that which occurred within 4 weeks of index arthroplasty. The primary outcome measure was infection control. Functional outcome was assessed with the Harris hip score. RESULTS: 27 of 38 patients were successfully treated, with no signs of infection or continued antibiotic treatment at the latest follow-up. Median Harris hip score was 86 (47-100) points. In 9 of the 11 patients for whom treatment failed, infection was successfully treated with 1-stage or 2-stage reimplantation or resection. Intraoperative cultures were positive in 36 hips, and the most frequently isolated organisms were Staphylococcus aureus and coagulase-negative staphylococci (CoNS). 15 infections were polymicrobial, and only 8 of them were successfully treated with debridement and retention of the implant. INTERPRETATION: Our data suggest that debridement and retention of the prosthesis is a reasonable treatment option in early PJI after primary hip arthroplasty, with satisfactory functional results. SN - 1745-3682 UR - https://www.unboundmedicine.com/medline/citation/22489892/Early_prosthetic_joint_infections_treated_with_debridement_and_implant_retention:_38_primary_hip_arthroplasties_prospectively_recorded_and_followed_for_median_4_years_ L2 - http://www.tandfonline.com/doi/full/10.3109/17453674.2012.678801 DB - PRIME DP - Unbound Medicine ER -