Two-Step Total Hip Arthroplasty in Deep Periprosthetic Infection

Abstract

Modern notions about surgical techniques for the treatment of deep purulent processes in the zone of hip implant are presented. In 13 cases surgical sanitation without implant removal was performed. In case of implant loosening treatment tactics was determined by the possibility of total revision arthroplasty. In 76 patients with periprosthetic infection surgical sanitation was aimed at inflammation arrest and restoration of extremity weight bearing after compelled implant removal. In 44 patients resection arthroplasty with formation of neoarthrosis by Girdlestone was performed. In 17 cases a two-step surgical intervention with implantation of antibiotic impregnated cement spacer followed by revision arthroplasty was used. Clinical, microbiologic and immunologic criteria of favourable treatment outcome with minimum risk of inflammatory process relapse were determined.