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Case Rep Orthop. 2016;2016:3621749. doi: 10.1155/2016/3621749. Epub 2016 Jan 19.

Bilateral One-Stage Revision of Infected Total Hip Arthroplasties: Report of Two Cases and Management of Antibiotic Therapy.

Author information

1
University of Lille, 59000 Lille, France; Orthopaedic Department, Lille University Hospital, rue Emile-Laine, 59037 Lille, France; Northwest Reference Center for Osteoarticular Infections (CRIOAC-G4 Lille-Tourcoing), Lille University Hospital, rue Emile-Laine, 59037 Lille, France.
2
Northwest Reference Center for Osteoarticular Infections (CRIOAC-G4 Lille-Tourcoing), Lille University Hospital, rue Emile-Laine, 59037 Lille, France; Department of Infectious Diseases, Gustave Dron Hospital of Tourcoing, rue du Président Coty, 59208 Tourcoing, France; Orthopaedic Department, Tourcoing Hospital, rue du Président Coty, 59208 Tourcoing, France.
3
University of Lille, 59000 Lille, France; Northwest Reference Center for Osteoarticular Infections (CRIOAC-G4 Lille-Tourcoing), Lille University Hospital, rue Emile-Laine, 59037 Lille, France; Department of Infectious Diseases, Gustave Dron Hospital of Tourcoing, rue du Président Coty, 59208 Tourcoing, France.

Abstract

Recommendations for the management of chronic and bilateral total hip arthroplasty (THA) infection are lacking. However, this type of infection involves medical problems concerning the management of the antibiotic therapy. We report two cases of such infections operated as one-stage revision. For each case, both hips were infected with the same bacteria (Staphylococcus caprae for one patient and methicillin-sensitive Staphylococcus aureus for the other). The probabilistic antibiotic treatment started during the first side (after harvesting intraoperative samples) did not prevent the culture of the bacteriologic harvested during the intervention of the second side. Cultures were positive for the same bacteria for both sides in the two cases presented herein. After results of intraoperative cultures, patients received culture-guided antibiotic therapy for three months and were considered cured at the end of a two-year follow-up. Our results suggest one-stage bilateral change of infected THA is a viable option and that early intraoperative antibiotic, started during the first-side exchange, does not jeopardize microbiological documentation of the second side. This work brings indirect arguments, in favor of the use of prophylactic antibiotics during revision of infected THA.

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