[Infection complications of total hip arthroplasty]

Abstract

The authors present an overview of the current views on etiology and diagnostics of infectious complications of total hip arthroplasty and analyze the possibilities of individual therapeutic procedures (debridement with the preservation of total hip arthroplasty, revision of the endoprosthesis, long-term antibiotic therapy, final resection arthroplasty, arthrodesis). They discuss the pending issues relating to the therapy of infectious complications of total hip arthroplasty (the duration of antibiotic therapy, the interval between the extraction and revision surgery of the endoprosthesis, the use of antibiotic-containing cement). Based on their own experience they recommend the revision surgery with the preservation of the implant, debridement and irrigation as the first step only in case of an early post-operative infection and in case of a late hematogenous acute infection. In case of chronic infection they recommend a two-step revision surgery using the cement spacer and the antibiotic therapy for 3 to 6 months. During this period the laboratory and clinical signs of the infection must be back to their normal. Long-term antibiotic therapy in dependence on microbial sensitivity is recommended.