BACKGROUND AND PURPOSE: Acute prosthetic infection is a serious problem. We report factors related to the incidence of acute infection and results of combined joint debridement and prolonged rifampicin-based antibiotic therapy. PATIENTS AND METHODS: Between 1998 and 2004, 14 acute infections occurred after 819 primary hip arthroplasties. The association between patient-related and surgical factors and the risk of infection were analyzed. Infections were treated with multiple joint lavage, debridement, 2 weeks of antibiotic therapy, and then oral antibiotics for a minimum of 6 months. RESULTS: There was a correlation between having a body mass index (BMI) of >or=30, and also more than 2 co-morbidities, and an increased risk of infection. Diabetes was a potential risk factor. Following our regime of treatment, 11 of 14 patients retained their prosthesis. 2 of 3 who required resection arthroplasty underwent successful staged revision, while the third patient had no further surgery because of being deemed unfit. INTERPRETATION: Primary joint replacement was salvaged in 11 of 14 patients. When successful re-implantation was included, 13 of 14 patients had a mobile prosthetic joint without further infection.
BACKGROUND AND PURPOSE: Acute prosthetic infection is a serious problem. We report factors related to the incidence of acute infection and results of combined joint debridement and prolonged rifampicin-based antibiotic therapy. PATIENTS AND METHODS: Between 1998 and 2004, 14 acute infections occurred after 819 primary hip arthroplasties. The association between patient-related and surgical factors and the risk of infection were analyzed. Infections were treated with multiple joint lavage, debridement, 2 weeks of antibiotic therapy, and then oral antibiotics for a minimum of 6 months. RESULTS: There was a correlation between having a body mass index (BMI) of >or=30, and also more than 2 co-morbidities, and an increased risk of infection. Diabetes was a potential risk factor. Following our regime of treatment, 11 of 14 patients retained their prosthesis. 2 of 3 who required resection arthroplasty underwent successful staged revision, while the third patient had no further surgery because of being deemed unfit. INTERPRETATION: Primary joint replacement was salvaged in 11 of 14 patients. When successful re-implantation was included, 13 of 14 patients had a mobile prosthetic joint without further infection.
Authors: O C El Helou; E F Berbari; B D Lahr; J E Eckel-Passow; R R Razonable; I G Sia; A Virk; R C Walker; J M Steckelberg; W R Wilson; A D Hanssen; D R Osmon Journal: Eur J Clin Microbiol Infect Dis Date: 2010-05-27 Impact factor: 3.267