Partial Component-Retained 2-Stage Reconstruction in the Treatment of Infected Hip Arthroplasty

J Arthroplasty. 2019 Nov;34(11):2770-2773. doi: 10.1016/j.arth.2019.06.030. Epub 2019 Jun 20.

Abstract

Background: It is considered the gold standard treatment for infected hip arthroplasty to remove and reimplant the corresponding whole set of implant components before and after infection control, but it usually causes substantial bone loss to remove the well-fixed cup or stem, which may increase the difficulty in reconstruction. We would like to determine whether infected hip arthroplasty can be treated without removal of a well-fixed cup or stem.

Methods: Patients with infected hip arthroplasty and a radiographically well-fixed, cementless cup or stem were selected. During the first surgical stage, we retained the stem or cup if these cannot be removed using a stem or cup extractor. We performed the reimplantation surgery after control of infection.

Results: From January 2008 to December 2016, 26 patients underwent partial component-retained 2-stage reconstruction. All the patients were free of infection with a mean follow-up time of 43.85 months.

Conclusion: Partial component-retained 2-stage reconstruction may be a treatment option for infected total hip arthroplasty with a well-fixed component in patients.

Keywords: 2-stage reconstruction; infected total hip arthroplasty; partial component retained; uncemented femoral component retention.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthritis, Infectious / surgery*
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Bone Cements
  • Debridement
  • Device Removal*
  • Female
  • Hip Prosthesis / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Prosthesis-Related Infections / surgery*
  • Reoperation
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Bone Cements