Two-stage reconstruction of infected hip joints

Abstract

Two-stage reconstruction using an antibiotic-loaded cement spacer is the preferred treatment of deep infection after total hip arthroplasty (THA). We evaluated the results of this technique for the treatment of primary hip infections. Nine consecutive patients with infected hip joints were treated using this technique. The average duration of follow-up was 42 months. Debridement and insertion of an antibiotic-loaded cement spacer was performed in the first stage. After eradication of infection, it was converted to THA in the second stage. Of the 9 hips, 8 were successfully converted to THA after an average of 23 weeks. One patient required spacer reinsertion, and another experienced reinfection after THA. Average Harris hip score improved from 38.37 before surgery to 57.62 between the 2 stages to 97.83 at final follow-up. Two-stage reconstruction using an antibiotic-loaded cement spacer was found to give satisfactory results for the treatment of hip infections with various etiologies.