Personal experience in the treatment of infection following total hip arthroplasty

Background. Infection after total hip arthroplasty is a serious problem in terms of treatment, patients suffering and economic impact. In this paper the authors report the results achieved in the treatment of 16 cases of infections following a total hip replacement, both primary and revision are reported. Methods. The therapy consisted of a simple surgical toilette or a two stages revision or a resection-arthroplasty according to Girdlestone. The choice was done basically taking into consideration the type of infection and the microrganism involved, the extension of the pathologic process and finally the general condition and patient's life attendance. Results. The efficacy of the treatment used was judged on the basis of the normalisation of parameters such as ESR, CRP and the absence of radiographic findings suggesting a periprosthetic sepsis at the end of the systemic antibiotic administration and at the follow-up visits for an average follow-up of 30 months (range 12 to 48 months). Conclusions. An early and superficial infection may be successfully treated with an accurate surgical debridement, while the late onset and the deep localisation of the process may require a more invasive procedures as one or two stages revisions or a resection- arthroplasty according to Girgdlestone.