Abstract
emphasize the importance of preoperative preparation and well-coordinated work of related specialists using a specific clinical instance. Case report Reported is a successful experience of two-stage treatment of the patient with hip PJI complicated with urinary bladder defect. A 40-year old male patient diagnosed with left-sided deep hip PJI Tsukayama type 3 was treated at department of infection surgery, Rostov Regional Clinical Hospital No. 2 in January 2019. Total hip arthroplasty performed in 2008 was complicated by migration of acetabulum component. A retroperitoneal bladder defect (pressure ulcer) was detected during the first stage of resection arthroplasty and placement of an antibacterial spacer. Urological procedure was performed in a delayed manner due to technical difficulties of implant removal, prolonged and traumatic procedure, and high blood loss. With the patient's condition stabilized cystoscopy and bilateral ultrasound guided percutaneous nephroureterostomy were performed. Prolonged antibacterial aetiotropic treatment was administered. The second stage of surgical treatment included revision hip arthroplasty using a tailored acetabular component and a standard revision femoral component performed at 6 months of debridement. Results Short- and long-term results were good with sustained remission achieved. Patient could walk unassisted using a cane and had a satisfactory ROM in the left hip with HHS scored 76.255. Conclusion Multiple disciplinary teamwork is appropriate for treatment of deep PJI with much coherence, coordinated efforts and expertise from diverse professionals.
Highlights
INTRODUCTIONThe amount of primary hip replacement procedures performed increases exponentially [1]
The risk of infection is 4 to 10 % with revision interventions, and the complication rate for Periprosthetic joint infection (PJI) ranges between 27 % and 32.3 % with revision interventions [3-6]
To demonstrate the need for a multidisciplinary approach to the treatment of patients with deep PJI and emphasize the importance of preoperative preparation and well-coordinated work of related specialists using a specific clinical instance
Summary
The amount of primary hip replacement procedures performed increases exponentially [1]. Case report A 40-year-old male patient was admitted to the infection surgical department of the Regional Clinical Hospital No 2 in January 2019 and was diagnosed with deep periprosthetic hip joint infection on the left Tsukayma type 3 He had undergone total hip replacement in 2008 with acetabular component migrated later. The patient reported sinus presenting with purulent discharge at the site of the postoperative scar of the left hip in 2017 and was treated as an outpatient He sought advice from the infection surgical service of the Regional Clinical Hospital No 2 in December 2018 and was diagnosed with PJI and migration of implant components. The patient was discharged from the hospital after 14 days
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