Abstract
Introduction: There are few published reports outlining the outcome of those patients who have undergone revision hip arthroplasty surgery for recurrent infection.
From a consecutive series of 114 patients who had undergone a two-stage exchange without prolonged antibiotic therapy we report the outcome of those patients who continued to have persistent infection.
Methods: Fourteen patients were identified, all with microbiologically proven recurrent deep infection. Seven patients have undertaken further attempts at cure by a two-stage exchange and where again a prolonged course of antibiotic therapy was not routinely used. Infection was eradicated in six out of the seven patients (84%). The mean follow-up of this group is 90 months (range 25–150 months).
Results: From the initial series an overall cure rate of 93% was seen. The other patient has a pseudarthrosis.
Seven patients elected not to undergo a further two-stage revision. Five patients have retained their arthroplasty with lifelong suppressive antibiotic therapy. One has a pseudarthrosis and one disarticulation has taken place for inadequate tissue cover.
Discussion: This series would suggest that in patients willing to undertake further surgery in an attempt to eradicate infection they stand a good chance of a successful outcome.
Correspondence should be addressed to Mr Peter Howard, Editorial Secretary, BHS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE, England.
