One-stage revision of infected cemented total hip arthroplasty

Abstract

A prospective study of a one-stage revision of infected cemented total hip arthroplasty was carried out in 102 consecutive cases using acrylic cement with 0.5 g of gentamicin in each 40 g pack as well as systemic and oral antibiotics. Thirty percent had a sinus tract at some stage before the revision. The most common infecting organism was coagulase-negative Staphylococcus, either as a pure growth or in combination with other organisms. The success rate was 91%, with an average follow-up study of three years and two months. The infection persisted in 9% of the cases. In three cases, infection was correlated with some aspect of the revision technique. The method gave a higher success rate than that obtained without the use of an antibiotic-loaded acrylic cement. Combined systemic and oral use of antibiotics appears to reduce the recurrence rate still further.