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World J Orthop. 2017 Mar 18;8(3):264-270. doi: 10.5312/wjo.v8.i3.264. eCollection 2017 Mar 18.

Results of single stage exchange arthroplasty with retention of well fixed cement-less femoral component in management of infected total hip arthroplasty.

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1
Wael A Rahman, Orthopaedic Department, Mansoura University, Mansoura, Dakahlia 35516, Egypt.

Abstract

AIM:

To investigate success of one stage exchange with retention of fixed acetabular cup.

METHODS:

Fifteen patients treated by single stage acetabular component exchange with retention of well-fixed femoral component in infected total hip arthroplasty (THA) were retrospectively reviewed. Inclusion criteria were patients with painful chronic infected total hip. The patient had radiologically well fixed femoral components, absence of major soft tissue or bone defect compromising, and infecting organism was not poly or virulent micro-organism. The organisms were identified preoperatively in 14 patients (93.3%), coagulase negative Staphylococcus was the infecting organism in 8 patients (53.3%).

RESULTS:

Mean age of the patients at surgery was 58.93 (± 10.67) years. Mean follow-up was 102.8 mo (36-217 mo, SD 56.4). Fourteen patients had no recurrence of the infection; one hip (6.7%) was revised for management of infection. Statistical analysis using Kaplan Meier curve showed 93.3% survival rate. One failure in our series; the infection recurred after 14 mo, the patient was treated successfully with surgical intervention by irrigation, and debridement and liner exchange. Two complications: The first patient had recurrent hip dislocation 12 years following the definitive procedure, which was managed by revision THA with abductor reconstruction and constrained acetabular liner; the second complication was aseptic loosening of the acetabular component 2 years following the definitive procedure.

CONCLUSION:

Successful in management of infected THA when following criteria are met; well-fixed stem, no draining sinuses, non-immune compromised patients, and infection with sensitive organisms.

KEYWORDS:

Complication; Infection; One stage exchange; Total hip arthroplasty

Conflict of interest statement

Conflict-of-interest statement: This study was not funded by any institution. The authors declare that they have no conflict of interest.

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