[The second stage revision for infected total hip arthroplasty using antibiotic-loaded cement prosthesis]

Wei Wei, Bo-Long Kou, Rong-Sen Ju, Hou-Shan Lü
Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery] 2007 February 15, 45 (4): 246-8

OBJECTIVE: To investigate the effect of two-stage revision for infected total hip arthroplasty (THA) using antibiotic-loaded cement prosthesis.

METHODS: From June 1999 to October 2004, 14 patients who admitted for infected primary total hip arthroplasty surgeries were performed revision surgery with antibiotic-loaded cement prosthesis in two-stage. The mean Harris score of pre-operation was 23. In the first stage operation, the following steps were performed, complete debridement, removal of infected prosthesis, implantation of cement spacer with antibiotics, treatment involved concomitant administration of 3 weeks of intravenous (IV) and 1 month of oral. After 6 months, antibiotic-loaded prosthesis was implanted in the second stage.

RESULTS: The mean follow-up was 18 months (7 - 26 months), no recurrent infection occurred in all 14 patients. The mean post-operation Harris score was 70.

CONCLUSIONS: The success of the protocol to control the delayed infection after THA are complete debridement, enough interval and using antibiotic-loaded cement prosthesis in two stage revision.

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