One-stage exchange effectively treats periprosthetic hip infection

Zeller V. J Bone Joint Surg Am. 2014;doi:10.2106/JBJS.L.01451.

According to this recently published study, one-stage exchange arthroplasty can lead to successful outcomes in select patients with periprosthetic hip infection.

“One-stage exchange arthroplasty is an effective surgical procedure in patients with periprosthetic hip infection who have good bone quality,” the authors wrote in their study abstract. “Precise identification of the microorganism(s) and prolonged administration of appropriate intravenous antibiotic therapy are key factors for successful treatment.”

Researchers included 157 patients with periprosthetic hip infections treated in a French referral center from November 2002 to March 2010. According to the abstract, the group included 99 primary hip arthroplasties, 27 revision arthroplasties and 31 cases in which the periprosthetic hip infection had been treated previously. Surgeons performed direct exchange in patients with chronic periprosthetic hip infection with no or minor bone loss. The researchers isolated a difficult-to-treat organism in 38% of cases. Patients underwent intravenous antibiotic therapy for 4 weeks to 6 weeks, followed by an oral regimen for 6 weeks to 8 weeks. The patients were followed for a minimum of 2 years.

After a median follow-up of 41.6 months, the researchers found two relapses, six new infections and nine revisions for mechanical reasons. There were 19 unrelated deaths and two related deaths.

Disclosure: The researchers report no relevant financial disclosures.