Revision of late periprosthetic infections of total hip endoprostheses: pros and cons of different concepts

Int J Med Sci. 2009 Sep 4;6(5):287-95. doi: 10.7150/ijms.6.287.

Abstract

Many concepts have been devised for the treatment of late periprosthetic infections of total hip prostheses. A two-stage revision with a temporary antibiotic-impregnated cement spacer and a cemented prosthesis appears to be the most preferred procedure although, in recent times, there seems to be a trend towards cementless implants and a shorter period of antibiotic treatment. Because of the differences in procedure, not only between studies but also within studies, it cannot be decided which period of parenteral antibiotic treatment and which spacer period is the most suitable. The fact that comparable rates of success can be achieved with different treatment regimens emphasises the importance of surgical removal of all foreign materials and the radical debridement of all infected and ischaemic tissues and the contribution of these crucial procedures to the successful treatment of late periprosthetic infections.

Keywords: hip endoprostheses; periprosthetic infections.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use*
  • Arthroplasty, Replacement, Hip / adverse effects
  • Arthroplasty, Replacement, Hip / methods*
  • Bacterial Infections / drug therapy*
  • Bacterial Infections / etiology
  • Bacterial Infections / surgery*
  • Hip Joint / pathology*
  • Hip Joint / surgery*
  • Humans
  • Prosthesis-Related Infections / drug therapy*
  • Prosthesis-Related Infections / etiology
  • Prosthesis-Related Infections / surgery*
  • Time Factors

Substances

  • Anti-Bacterial Agents