Risk factors associated with acute hip prosthetic joint infections and outcome of treatment with a rifampinbased regimen

Abstract

Background and purpose: Acute prosthetic infection is a serious problem. We report factors related to the incidence of acute infection and results of combined joint debridement and prolonged rifampicin-based antibiotic therapy.

Patients and methods: Between 1998 and 2004, 14 acute infections occurred after 819 primary hip arthroplasties. The association between patient-related and surgical factors and the risk of infection were analyzed. Infections were treated with multiple joint lavage, debridement, 2 weeks of antibiotic therapy, and then oral antibiotics for a minimum of 6 months.

Results: There was a correlation between having a body mass index (BMI) of >or=30, and also more than 2 co-morbidities, and an increased risk of infection. Diabetes was a potential risk factor. Following our regime of treatment, 11 of 14 patients retained their prosthesis. 2 of 3 who required resection arthroplasty underwent successful staged revision, while the third patient had no further surgery because of being deemed unfit.

Interpretation: Primary joint replacement was salvaged in 11 of 14 patients. When successful re-implantation was included, 13 of 14 patients had a mobile prosthetic joint without further infection.