A Comparison between Methicillin Resistant Organism and Non- Methicillin Resistant Organism in 2-Stage Reimplantation of Periprosthetic Hip Infection

Abstract

Background: The prevalence of resistant organisms has increased in periprosthetic hip infection. The purpose of this study is to evaluate the effectiveness of staged reimplantation for the treatment of periprosthetic hip infection caused by methicillin resistant microorganisms. Methods: We performed a retrospective case-control study on 25 consecutive patient (15 men, 10 women) who had periprosthetic hip infection treated using a 2-stage reimplantation. Results: 13 patients infected by methicillin resistant microorganisms were compared with 12 patients infected by non-methicillin resistant microorganisms. The 2-stage reimplantation was possible in all patients. At a mean follow-up of 4.8 years, no significant differences were found between 2 groups with age, sex, body mass index, diabetes, primary diagnosis and kind of primary hip arthroplasty. But methicillin resistant group had much longer period with intravenous antibiotics and oral antibiotics. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) was much higher in methicillin resistant group after 2-stage reimpantation. Harris Hip Score was lower in methicillin resistant group after 2-stage reimplantation. There were 3 recurrent infections after 2-stage reimplantation in methicillin resistant group. But there was no recurrent infection in non-methicillin resistant group. Conclusion: Periprosthetic hip infection caused by methicillin resistant bacterial strain need cautious care of operation and infection control.