Reimplantation in infection: a 12-year experience.

Overview

Three groups of patients underwent reimplantation for infected hip prostheses during the period from 1968 to 1979. The first group (N = 19) was diagnosed mainly by hip aspiration and treated with antibiotics selected by disc sensitivity and one-stage reimplantation in 14 hips. The second group (N = 26) was diagnosed by strict hip infection criteria and treated with a similar antibiotic regimen. Reimplantation was performed in one stage in 13 patients and in two stages in the remaining 13. The third group (N = 16) was diagnosed by the same criteria but treated with standardized bactericidal antibiotics evaluated by the tube dilution method. There were five one-stage reimplantations, ten two-stage, and one radical debridement without removal of components. The follow-up period ranged from two to 12 years. The present guidelines for reimplantation include subacute hip sepsis caused by susceptible bacteria, according to tube dilution methods in immunocompetent patients with adequate soft tissue and bone stock to allow a satisfactory biomechanical reconstruction. Patients should be aware of the risk of recurrence of infection, persistent pain, limited durability, and further surgical treatment.