Debridement, antibiotics and implant retention for prosthetic joint infection: comparison of outcomes between total hip arthroplasty and hip resurfacing

• Published in: International orthopaedics 2022-12, Vol.46 (12), p.2799-2806
• Main Authors: Castanet, Enrick, Martinot, Pierre, Dartus, Julien, Senneville, Eric, Migaud, Henri, Girard, Julien
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents - therapeutic use; Arthritis, Infectious; Arthroplasty, Replacement, Hip - adverse effects; Case-Control Studies; Debridement; Humans; Life Sciences; Medicine; Medicine & Public Health; Original Paper; Orthopedics; Retrospective Studies
• ISSN: 0341-2695; 1432-5195; 1432-5195
• DOI: 10.1007/s00264-022-05522-x

Introduction The management of prosthetic joint infection (PJI) has been widely studied in the context of total hip arthroplasty (THA). However, the outcomes of debridement, antibiotics and implant retention (DAIR) for PJI have never been compared between hip resurfacing arthroplasty (HRA) and THA. This led us to carry out a retrospective case–control study comparing the surgical treatment of post-operative infections between HRA and THA to determine the infection remission rate and the medium-term functional outcomes. Methods This single-centre case–control study analysed 3056 HRA cases of which 13 patients had a PJI treated by DAIR. These patients were age-matched with 15 infected THA hips treated by DAIR and modular component exchange (controls). Their survival (no recurrence of the infection) was compared and factors that could affect the success of the DAIR were explored: sex, body mass index, age at surgery, presence of haematoma, type of bacteria present and antibiotic therapy. Results At a mean follow-up of five years (2–7), the infection control rate was significantly higher in the HRA group (100% [13/13]) than in the THA group (67% [10/15]) ( p  = 0.044). More patients in the THA group had undergone early DAIR (