Infection management in total hip replacement.

Early diagnosis and determined management of infection after hip replacement are the prerequisites for good end results. Infections that manifest themselves during the first 6 weeks after a prosthetic implant can be mastered by local debridement. The implant can thus be saved, and the functional performance as well. Infections that appear after this 6-week period may require temporary removal of the implant in order to control the infection. When the clinical aspects and laboratory data indicate the infection is under control, the hip endoprosthesis can be reimplanted with a very low rate of recurrence. The method applied for removal of implants and bone cement is of utmost importance for the final results, and a extremely diligent surgical technique is the basis for long-term management of infection and good functional performance. Resection arthroplasty is not the treatment of choice anymore for infected hip prostheses and should be restricted to special cases.