Hip disarticulation for severe lower extremity infections

Clin Orthop Relat Res. 2009 Jul;467(7):1721-6. doi: 10.1007/s11999-009-0769-y. Epub 2009 Mar 10.

Abstract

Hip disarticulation is rarely performed for infections and variable mortality rates have been reported. We determined the number of deaths following hip disarticulation for severe lower extremity infections in 15 patients. Indications for hip disarticulation were necrotizing soft tissue infections in seven patients and persistent infections of the proximal thigh in eight patients. The most common microorganism was Staphylococcus aureus, present in eight patients. Hip disarticulation was performed emergently in seven patients and electively in eight patients. All patients survived the operation and at 1 month postoperatively 14 of 15 patients were alive. Hip disarticulation for these severe infections had high survival, even when performed emergently for life-threatening infections. We believe hip disarticulation is a reasonable option treating severe infections of the lower extremity and should be part of the armamentarium of the orthopaedic surgeon.

Level of evidence: Level IV, therapeutic case series.

MeSH terms

  • Adolescent
  • Adult
  • Aged, 80 and over
  • Amputation / mortality
  • Debridement
  • Disarticulation / mortality*
  • Fasciitis, Necrotizing / mortality*
  • Fasciitis, Necrotizing / surgery*
  • Female
  • Gangrene / mortality*
  • Gangrene / surgery*
  • Hip Joint / surgery*
  • Humans
  • Leg
  • Male
  • Middle Aged
  • Osteomyelitis / mortality
  • Osteomyelitis / surgery
  • Prosthesis-Related Infections / mortality
  • Prosthesis-Related Infections / surgery
  • Retrospective Studies
  • Severity of Illness Index