Extended trochanteric osteotomy for 2-stage revision of infected total hip arthroplasty

J Arthroplasty. 2005 Apr;20(3):294-301. doi: 10.1016/j.arth.2004.09.060.

Abstract

We evaluate the rate of osteotomy healing, implant stability, and eradication of infection when an extended trochanteric osteotomy, with interval placement of an antibiotic-impregnated cement spacer and delayed osteotomy fixation, is used to treat the chronically infected total hip arthroplasty. Thirteen cases were followed for a minimum of 2 years. All patients had complete healing of the extended trochanteric osteotomy within 6 months. At an average follow-up of 39 months, recurrent infection occurred in 3 (23%) patients. Femoral component subsidence of 5 mm occurred in 2 patients, both of which had recurrent infection. Extended trochanteric osteotomy with interval placement of an articulating antibiotic-impregnated cement spacer and delayed osteotomy fixation permits reliable healing of the osteotomy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip*
  • Bone Cements / therapeutic use
  • Chronic Disease
  • Debridement
  • Device Removal
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Opportunistic Infections / diagnostic imaging
  • Opportunistic Infections / surgery
  • Osteotomy / methods*
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / surgery*
  • Prosthesis Failure
  • Radiography
  • Reoperation
  • Retrospective Studies
  • Surgical Wound Infection / diagnostic imaging
  • Surgical Wound Infection / surgery*
  • Tobramycin / therapeutic use
  • Wound Healing / physiology

Substances

  • Bone Cements
  • Tobramycin