Prothèse de hanche infectée : le point de vue du chirurgien

Abstract

An infected hip prosthesis is a serious complication. In addition to the various clinical presentations, the diagnosis is not always clear and the therapeutic strategies contrast conservative treatments by debridement, antibiotics, and implant retention with non-conservative treatments requiring an exchange arthroplasty. Joint aspiration confirms the diagnosis of infection and determines the germ's sensitivity that guides peri-operative antibiotic therapy. The surgical indication must be based on a pragmatic classification in order to avoid inappropriate intervention. The irrigation and debridement, attractive for his simplicity, remains recommended in case of acute infection, but it does not provide the same success rate than one-stage exchange arthroplasty, whose contraindications are increasingly more relative. In the absence of effective multidisciplinary approach or in a complex situation, the infected patient should be referred to a referral center for complex osteoarticular infection.