The Journal of Bone and Joint Surgery, Vol 76, Issue 3 349-359, Copyright © 1994 by Journal of Bone and Joint Surgery, Inc

JOURNAL CONTENTS

The use of porous prostheses in delayed reconstruction of total hip replacements that have failed because of infection

BJ Nestor, AD Hanssen, R Ferrer-Gonzalez and RH Fitzgerald
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota 55905.

Between March 1984 and March 1989, thirty-four patients who had an infection at the site of a cemented total hip prosthesis were managed with resection arthroplasty and delayed implantation of a porous total hip prosthesis without cement. The interval from the time of the resection arthroplasty to the implantation of another prosthesis averaged eight months (range, three to nineteen months). At an average of forty-seven months (range, twenty-four to seventy-two months) after the reimplantation, six patients (18 per cent) had recurrence of the infection. Patients who had rheumatoid arthritis were at significantly higher risk for the development of a recurrent infection (p < 0.01). Of the twenty-eight patients who did not have a recurrent infection, six had definite radiographic evidence of loosening of the femoral component at the latest follow-up evaluation. For twenty-five of the twenty-eight patients, sufficient data were available for calculation of the Mayo Clinic hip score; only fourteen (56 per cent) of these patients had a satisfactory functional outcome. The high (68 per cent) rate of complications and the long-term durability of the prosthesis in these patients remain a concern. The fact that 18 per cent of the patients had a recurrent infection suggests that avoidance of the use of bone cement does not improve the rate of resolution of infection after a delayed revision operation in patients who have an infection following a total hip arthroplasty.
CiteULike    Connotea    Del.icio.us    Technorati    What's this?

This article has been cited by other articles:

				G. Bori, A. Soriano, S. Garcia, C. Mallofre, J. Riba, and J. Mensa Usefulness of Histological Analysis for Predicting the Presence of Microorganisms at the Time of Reimplantation After Hip Resection Arthroplasty for the Treatment of Infection J. Bone Joint Surg. Am., June 1, 2007; 89(6): 1232 - 1237. [Abstract] [Full Text] [PDF]

				P.-H. Hsieh, C.-H. Shih, Y.-H. Chang, M. S. Lee, W.-E. Yang, and H.-N. Shih Treatment of deep infection of the hip associated with massive bone loss: TWO-STAGE REVISION WITH AN ANTIBIOTIC-LOADED INTERIM CEMENT PROSTHESIS FOLLOWED BY RECONSTRUCTION WITH ALLOGRAFT J Bone Joint Surg Br, June 1, 2005; 87-B(6): 770 - 775. [Abstract] [Full Text] [PDF]

				M. A. Buttaro, R. Pusso, and F. Piccaluga Vancomycin-supplemented impacted bone allografts in infected hip arthroplasty: TWO-STAGE REVISION RESULTS J Bone Joint Surg Br, March 1, 2005; 87-B(3): 314 - 319. [Abstract] [Full Text] [PDF]

				P.-H. Hsieh, C.-H. Shih, Y.-H. Chang, M. S. Lee, H.-N. Shih, and W.-E Yang Two-Stage Revision Hip Arthroplasty for Infection: Comparison Between the Interim Use of Antibiotic-Loaded Cement Beads and a Spacer Prosthesis J. Bone Joint Surg. Am., September 1, 2004; 86(9): 1989 - 1997. [Abstract] [Full Text] [PDF]

				S. J. Wentworth, B. A. Masri, C. P. Duncan, and C. B. Southworth Hip Prosthesis of Antibiotic-Loaded Acrylic Cement for the Treatment of Infections Following Total Hip Arthroplasty J. Bone Joint Surg. Am., November 25, 2002; 84(90002): S123 - 128. [Full Text] [PDF]

				G. M. Robbins, B. A. Masri, D. S. Garbuz, and C. P. Duncan Primary Total Hip Arthroplasty After Infection J. Bone Joint Surg. Am., April 1, 2001; 83(4): 601 - 601. [Full Text]

				D. C. Mears and J. H. Velyvis Primary Total Hip Arthroplasty After Acetabular Fracture J. Bone Joint Surg. Am., September 1, 2000; 82(9): 1328 - 1328. [Full Text] [PDF]

				A. D. HANSSEN and J. A. RAND Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Evaluation and Treatment of Infection at the Site of a Total Hip or Knee Arthroplasty*{{dagger}} J. Bone Joint Surg. Am., June 1, 1998; 80(6): 910 - 22. [Full Text]

				E. L. MASTERSON, B. A. MASRI, and C. P. DUNCAN Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Treatment of Infection at the Site of Total Hip Replacement*{{dagger}} J. Bone Joint Surg. Am., November 1, 1997; 79(11): 1740 - 9. [Full Text]