Two-stage cementless total hip arthroplasty for chronic infection after the internal fixation of the proximal femoral fracture
10.3760/cma.j.issn.0253-2352.2012.09.002
- VernacularTitle:股骨近端骨折内固定术后慢性感染的二期全髋关节置换
- Author:
Pengde KANG
;
Jing YANG
;
Bin SHEN
;
Zongke ZHOU
;
Fuxing PEI
- Publication Type:Journal Article
- Keywords:
Femoral fractures;
Internal fixators;
Infection;
Arthroplasty,replacement,hip
- From:
Chinese Journal of Orthopaedics
2012;32(9):811-816
- CountryChina
- Language:Chinese
-
Abstract:
Objective To retrospectively analyze the short-term clinical effects of the two-stage cementless total hip arthroplasty in the treatment of chronic infection after the internal fixation of the adult proximal femoral fracture.Methods From June 2006 to June 2011,9 patients who had suffered a chronic infection after an internal fixation of the proximal femoral fracture,including 8 males and 1 female,aged from 31 to 74 years (average,52.6 years),were treated with two-stage cementless total hip arthroplasty.There were 3 cases of femoral neck fracture,and 6 cases of intertrochanteric fracture.In the first stage,after surgical debridement and thorough removal of all the implants,an antibiotic-loaded cement spacer was implanted.All patients postoperatively underwent intravenous and oral antibiotics,and the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were tested.When the values of ESR and CRP become normal,the second stage operation using cementless components was performed.Results The presence of infection was confirmed by a positive culture of joint fluid obtained intraoperatively in two cases;one case was staphylococcus aureus and another one was staphylococcus epidermidis.The second stage arthroplasty was performed 6-14 months (average,9 months) after the first stage operation.All 9 patients were followed up for an average of 23.2 months (range,6 to 50 months).No recurrent infection,component loosening,bone osteolysis and cement spacer or component dislocation occurred.The Harris score improved from 74.6 (range,64 to 86) before the first stage operation to 90.9 (range,86 to 97) at the final follow-up.Conclusion The two-stage cementless total hip arthroplasty is an effective strategy for the treatment of chronic infection after the internal fixation of the adult proximal femoral fracture.
