The arthroscopic drainage, irrigation, and débridement of late, acute total hip arthroplasty infections: Average 6-year follow-up

• Published in: The Journal of arthroplasty 1999-12, Vol.14 (8), p.903-910
• Main Authors: Hyman, Jon L., Salvati, Eduardo A., Laurencin, Cato T., Rogers, David E., Maynard, Michael, Brause, Barry D.
• Format: Article
• Language: English
• Subjects: Acute Disease; Aged; Aged, 80 and over; Anti-Bacterial Agents - therapeutic use; Arthroscopy; Drainage; Female; Gram-Positive Bacterial Infections - drug therapy; Gram-Positive Bacterial Infections - microbiology; Gram-Positive Bacterial Infections - surgery; hip arthroscopy; Hip Prosthesis - adverse effects; Humans; infection; Male; Pain Management; Perioperative Care; Prosthesis-Related Infections - drug therapy; Prosthesis-Related Infections - microbiology; Prosthesis-Related Infections - surgery; Range of Motion, Articular; Therapeutic Irrigation; total hip arthroplasty
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1016/S0883-5403(99)90001-3

We present our experience with arthroscopy for the treatment of late, acute periprosthetic hip infections in 8 consecutive patients, treated from 1989 to 1994. After a hip aspiration confirmed the presence of bacterial infection, all patients underwent prompt arthroscopic treatment, which consisted of drainage, lavage, and débridement. Postoperatively, patients were given 2 to 6 weeks of intravenous antibiotics, followed by long-term oral antibiotic suppression. At a mean follow-up of 70 months (range, 29–104 months), no recurrence of infection occurred. No progressive radiographic loosening was noted. Based on this initial study, we believe that arthroscopic irrigation and débridement can benefit well-selected patients who suffer late, acute hip periprosthetic infections. Effective treatment requires early diagnosis, prompt arthroscopic débridement, well-fixed components, a sensitive microorganism, and patient tolerance to and compliance with the antibiotic therapy.