Peri-prosthetic hip infections: in favour of one-stage

Abstract

Although it does offer certain obvious advantages, the one-staged revision approach in infected THA remains rare in the field of orthopaedics. Besides the reduced number of surgical interventions for patients, it is associated with a decreased inpatient hospital stay and quicker mobilisation. Furthermore, it might be the more cost-effective approach and enables a reduced duration of post-operative systemic antibiotics, usually less than 14 days in our setting. Technically speaking, the presence of a positive culture of a pre-operative aspiration and respective antibiogram are mandatory requirements. A general cemented implant fixation using topical antibiotics is the treatment of choice for single-staged procedures. The key to surgical success is based on the well-defined and detailed intra-hospital infrastructure, including a meticulous pre-operative hip aspiration regime, pre-operative planning and an aggressive intra-operative surgical approach.