Abstract

VEDOYA, Santiago P et al. Revisión en dos tiempos del reemplazo total de cadera infectado. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2014, vol.79, n.2, pp.117-123. ISSN 1852-7434.

Background: Infection of a total hip arthroplasty is one of the most serious complications, and the revision can be accomplished in one or two surgical stages. The aim of this study was to evaluate a prospective series of patients with infected total hip arthroplasty with a two-stage revision. Methods: We evaluated 72 two-stage revisions of infected total hip arthroplasty (subacute and chronic), in 71 patients, with an average follow-up of 6.4 years (1 to 12 years). A cement spacer with antibiotics was used in all cases. Results: Infection resolved in 96% of cases (69 hips). We used 59 spacers which were "hand-made" in the operating room (82%) and 13 prefabricated ones. The most common pathogen was coagulase-negative Staphylococcus (23 cases). There were 8 complications: 4 spacer dislocations, 2 perispacer fractures and 2 spacer fractures. Conclusion: Two-stage revisions show excellent cure rates of infection. Success depends on an extensive surgical debridement, on the use of a spacer with the appropriate antibiotic and on a customized postoperative antibiotic protocol.

Keywords : Infected hip arthroplasty; Revision; Two-stages; Antibiotics; Spacer.

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