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One-stage revision arthroplasty for infected hip replacements.

Muñoz-Mahamud E, Gallart X, Soriano A - Open Orthop J (2013)

Bottom Line: In the case of a one-stage procedure, the patient is exposed to a single major procedure and therefore lower cumulative perioperative risk.A functional prosthesis replacement is completed without exposure to the complications associated with spacers.In addition, there are also benefits both financially and in terms of resource allocation.

View Article: PubMed Central - PubMed

Affiliation: Orthopaedics and Trauma Surgery Department, Hospital Clinic, University of Barcelona, C/Villarroel 170, Barcelona 08036, Barcelona, Spain ; Bone and Joint Infection Unit, Hospital Clinic, University of Barcelona, C/Villarroel 170, Barcelona 08036 Barcelona, Spain.

ABSTRACT
Infection remains a serious complication after total hip arthroplasty (THA) and is a leading cause of hip revision surgery. It is currently accepted that removal of the prosthesis is essential to curing an infection when facing chronic PJIs with prosthesis loosening. In order to avoid the disadvantages of a two-stage approach, some authors have proposed a one-stage hip revision for the treatment of hip prosthesis infection in selected patients using not only antibiotic-loaded cemented components but also cementless implant. In the case of a one-stage procedure, the patient is exposed to a single major procedure and therefore lower cumulative perioperative risk. A functional prosthesis replacement is completed without exposure to the complications associated with spacers. In addition, there are also benefits both financially and in terms of resource allocation.

No MeSH data available.


Related in: MedlinePlus

An 79-year-old man with surgical confirmation of infectedright hip prosthesis (Staphylococcus epidermidis). Axial CT imageallowed confirming placement of the needle in the middle of theprosthetic fluid. Positive cultures to Staphylococcus epidermidiswere obtained on CT-Aspiration.
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Figure 3: An 79-year-old man with surgical confirmation of infectedright hip prosthesis (Staphylococcus epidermidis). Axial CT imageallowed confirming placement of the needle in the middle of theprosthetic fluid. Positive cultures to Staphylococcus epidermidiswere obtained on CT-Aspiration.

Mentions: Culture of the synovial fluid obtained through hip aspiration is a useful technique not only to confirm the presence of microorganisms, but to identify the particular microorganism responsible for the infection. However, it is technically difficult to perform and is not exempt from either complications or false negative results. The technique is generally performed under fluoroscopic X-ray guidance. The position of the needle can be confirmed by arthrography. In the past few years several articles have appeared on the usefulness of CT imaging (Fig. 3) in the evaluation of painful infection at the site of hip prosthesis before surgery [26].


One-stage revision arthroplasty for infected hip replacements.

Muñoz-Mahamud E, Gallart X, Soriano A - Open Orthop J (2013)

An 79-year-old man with surgical confirmation of infectedright hip prosthesis (Staphylococcus epidermidis). Axial CT imageallowed confirming placement of the needle in the middle of theprosthetic fluid. Positive cultures to Staphylococcus epidermidiswere obtained on CT-Aspiration.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3722544&req=5

Figure 3: An 79-year-old man with surgical confirmation of infectedright hip prosthesis (Staphylococcus epidermidis). Axial CT imageallowed confirming placement of the needle in the middle of theprosthetic fluid. Positive cultures to Staphylococcus epidermidiswere obtained on CT-Aspiration.
Mentions: Culture of the synovial fluid obtained through hip aspiration is a useful technique not only to confirm the presence of microorganisms, but to identify the particular microorganism responsible for the infection. However, it is technically difficult to perform and is not exempt from either complications or false negative results. The technique is generally performed under fluoroscopic X-ray guidance. The position of the needle can be confirmed by arthrography. In the past few years several articles have appeared on the usefulness of CT imaging (Fig. 3) in the evaluation of painful infection at the site of hip prosthesis before surgery [26].

Bottom Line: In the case of a one-stage procedure, the patient is exposed to a single major procedure and therefore lower cumulative perioperative risk.A functional prosthesis replacement is completed without exposure to the complications associated with spacers.In addition, there are also benefits both financially and in terms of resource allocation.

View Article: PubMed Central - PubMed

Affiliation: Orthopaedics and Trauma Surgery Department, Hospital Clinic, University of Barcelona, C/Villarroel 170, Barcelona 08036, Barcelona, Spain ; Bone and Joint Infection Unit, Hospital Clinic, University of Barcelona, C/Villarroel 170, Barcelona 08036 Barcelona, Spain.

ABSTRACT
Infection remains a serious complication after total hip arthroplasty (THA) and is a leading cause of hip revision surgery. It is currently accepted that removal of the prosthesis is essential to curing an infection when facing chronic PJIs with prosthesis loosening. In order to avoid the disadvantages of a two-stage approach, some authors have proposed a one-stage hip revision for the treatment of hip prosthesis infection in selected patients using not only antibiotic-loaded cemented components but also cementless implant. In the case of a one-stage procedure, the patient is exposed to a single major procedure and therefore lower cumulative perioperative risk. A functional prosthesis replacement is completed without exposure to the complications associated with spacers. In addition, there are also benefits both financially and in terms of resource allocation.

No MeSH data available.


Related in: MedlinePlus