Treatment results with debridement and retention of infected hip prostheses

Abstract

A retrospective systematic review of the management of a periprosthetic joint infection (PJI) cohort of 78 cases was conducted at a single-centre, middle-sized Norwegian hospital from 1997 to 2007. We analysed 40 cases that were managed by surgical debridement with hip prosthesis retention followed by long-lasting pathogen-directed antibiotic therapy. A follow-up time of 58 to 510 weeks free from PJI relapse occurred in 27 of 40 PJI cases (67.5%). The need for a more advanced secondary orthopaedic procedure was recognized in 13 cases. The pathogen responsible for PJI was recovered in only 80% of cases, hence 20% were managed as culture-negative PJI. In cases without prior hip infection or hip surgery, success rate reached 96.3%. Multiple risk factors were found in most cases undergoing PJI relapse. Debridement with hip prosthesis retention should be restricted to only current management guidelines.