Treatment of acute hematogenous periprosthetic joint infection following total hip arthroplasty with debridement and prosthesis retention
SONG Xing-gui
CHAI Wei
LI Xin
NI Ming
CHEN Ji-ying
Abstract：Objective To investigate the effectiveness of antibiotics combined with debridement for acute hematogenous periprosthetic joint infection ( PJI ) with retention of hip implant. Methods We retrospectively collected data from 14 cases of acute hematogenous periprosthetic joint infection following total hip arthroplasty ( THA ), which were managed with debridement, antibiotics and implant retention ( DAIR ) procedure from January 2002 to September 2014. Before the debridement surgery, erythrocyte sedimentation rate ( ESR ), C-reactive protein ( CRP ) and synovial fluid culture were routinely measured. Adequate antibiotics therapy was applied postoperatively. The outcome of DAIR treatment was evaluated after a minimal follow-up of 2 years. Results Eleven of 14 cases showed definite microorganisms with more than 2 samples including 3 strains of Staphylococcus aureus, 1 enterococcus, 1 Staphylococcus epidermidis, 1 Streptococcus constellatus, 1 Candida albicans, 1 Klebsiella pneumoniae and 3 cases of polymicrobial infection, the rest were culture-negative. At a mean follow-up of 66.2 months, there were 8 cases that retained the prosthesis without further evidence of infection. The success rate was 57.1％. Conclusions Debridement, antibiotic treatment and implant retention has good therapeutic effects in the treatment of acute hematogenous periprosthetic joint infection following THA.
Keywords：ArthroplastyreplacementhipBacterial infectionsDebridementAcute hematogenous infection
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 655-660 )