La prothèse de hanche infectée : le point de vue du médecin

Abstract

Total hip replacement is one of the most common orthopaedic surgeries, and its most frequent indication is osteoarthritis. Prosthetic Hip infection (PHI) can occur in 1 to 1.5 percent of cases. Some risk factors have been identified (modifiable or not), such as obesity, diabetes, corticosteroids, malnutrition, anemia, or smoking. These risk factors must be screened before surgery, and be corrected preoperatively to decrease the risk. Sometimes surgery must be delayed or abandoned. Prescription of some of our chronic inflammatory rheumatism patients’ immunosuppressive drugs must be modified and steroids prescription must be lowered under 10mg per day. PHI treatment is based on 2 axes: surgery and antibiotic therapy. In this paper we describe the most important molecules the rheumatologist has to know in correlation with the most frequent microorganism found in prosthesis infections, and how to deal with immunosuppressive drugs we usually prescribe to our RA patients.