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The Journal of Bone and Joint Surgery 83:601 (2001)
© 2001 The Journal of Bone and Joint Surgery, Inc.

Instructional Course Lecture

Primary Total Hip Arthroplasty After Infection

G. M. Robbins, MB, BS, FRCS(ORTH), B. A. Masri, MD, FRCS(C), D. S. Garbuz, MD, MHSc, FRCS(C) and C. P. Duncan, MB, MSc, FRCS(C)

An Instructional Course Lecture, American Academy of Orthopaedic Surgeons
G.M. Robbins, MB, BS, FRCS(Orth)
B.A. Masri, MD, FRCS(C)
D.S. Garbuz, MD, MHSc, FRCS(C)
C.P. Duncan, MB, MSc, FRCS(C)
Division of Reconstructive Orthopaedics (G.M.R., B.A.M., and D.S.G.) and Department of Orthopaedics (C.P.D.), University of British Columbia, Laurel Pavilion, 910 West Tenth Avenue, Third Floor, Vancouver, BC V5Z 4E3, Canada. E-mail address for B.A. Masri:masri@interchange.ubc.ca. E-mail address for D.S. Garbuz: garbuz@home.com. E-mail address for C.P. Duncan: cduncan@interchange.ubc.ca
Printed with permission of the American Academy of Orthopaedic Surgeons. A modified version of this article, as well as other lectures presented at the Academy’s Annual Meeting, appeared in March 2001 in Instructional Course Lectures, Volume 50. The complete volume can be ordered online at www.aaos.org, or by calling 800-626-6726 (8 a.m.-5 p.m., Central time).
The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.


   Introduction
 
Only a few of the more than 200,000 total hip arthroplasties performed annually in the United States are done after an infection of the hip joint or the proximal aspect of the femur.

Although some infections produce severe early destruction of the hip joint, most patients, if treated promptly, regain good hip function and do not present again until much later in life, when secondary degenerative changes have occurred1. It is therefore necessary to be aware of the possibility of a previous infection and to inquire about it specifically.

The first recurrence of bone infection may be delayed for many decades. Gallie2 reported a case of femoral osteomyelitis in a ten-year-old girl that did not recur until after nearly eighty years. The risk that a previous infection of the hip region poses to a hip prosthesis is multifactorial. The type of infection (osteomyelitis or septic arthritis), the level of . . . [Full Text of this Article]


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