Treatment of Deep Infection after Total Hip Replacement
Nine hips of 8 cases with deeply infected total hip replacement (THR) were treated in our clinic and at a related hospital. There was early infection in 2 hips (one rheumatoid and one avascular necrosis), and late infection in 7 hips (all rheumatoid) . The infection rate in the total number of THRs...
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| Published in | Japanese Journal of Rheumatism and Joint Surgery Vol. 8; no. 4; pp. 597 - 602 |
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| Main Author | |
| Format | Journal Article |
| Language | English Japanese |
| Published |
Japanese Society for Joint Diseases
1989
日本関節病学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0287-3214 1884-9059 |
| DOI | 10.11551/jsjd1982.8.597 |
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| Abstract | Nine hips of 8 cases with deeply infected total hip replacement (THR) were treated in our clinic and at a related hospital. There was early infection in 2 hips (one rheumatoid and one avascular necrosis), and late infection in 7 hips (all rheumatoid) . The infection rate in the total number of THRs (480 hips) in our clinic was 1.25%; 3.8% in rheumatoid patients and 0.3 % in osteoarthritis. The organisms involved were St. aureus in 4 hips, St. epidermidis in 3, St. f aecalis in one and serratia in one. Two hips (St. aureus, St. epidermidis) were cured with wide curettage and wire removal combined with continuous irrigation. Total removal of the THR system was carried out in 5 hips (4 cases) with irrigation. Two cases died due to sepsis after curettage. The other 6 cases were followed up at an average of 54 months, ranging from 8 to 130 months. No signs of infection were detected in any of them. Clinically, 3 patients (one curettagge and 2 prosthesis) were able to walk with crutches, another was ambulatory with a wheel chair, and the other 2 rheumatoid patients were bedridden. At present, no re-replacement surgery has been scheduled due to individuals' situations and unwillingness. |
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| AbstractList | Nine hips of 8 cases with deeply infected total hip replacement (THR) were treated in our clinic and at a related hospital. There was early infection in 2 hips (one rheumatoid and one avascular necrosis), and late infection in 7 hips (all rheumatoid) .The infection rate in the total number of THRs (480 hips) in our clinic was 1.25%; 3.8% in rheumatoid patients and 0.3 % in osteoarthritis. The organisms involved were St. aureus in 4 hips, St. epidermidis in 3, St. f aecalis in one and serratia in one.Two hips (St. aureus, St. epidermidis) were cured with wide curettage and wire removal combined with continuous irrigation. Total removal of the THR system was carried out in 5 hips (4 cases) with irrigation. Two cases died due to sepsis after curettage. The other 6 cases were followed up at an average of 54 months, ranging from 8 to 130 months. No signs of infection were detected in any of them. Clinically, 3 patients (one curettagge and 2 prosthesis) were able to walk with crutches, another was ambulatory with a wheel chair, and the other 2 rheumatoid patients were bedridden. At present, no re-replacement surgery has been scheduled due to individuals' situations and unwillingness. |
| Author | YOSHIDA, Kazuhisa |
| Author_FL | 吉田 和久 |
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| DOI | 10.11551/jsjd1982.8.597 |
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| DocumentTitleAlternate | ＴＨＲ後深部感染症の治療経験 |
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| PublicationTitle | Japanese Journal of Rheumatism and Joint Surgery |
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| PublicationTitle_FL | 日関外誌 Jpn. J. Rheum.Joint Surg 日本リウマチ・関節外科学会雑誌 |
| PublicationYear | 1989 |
| Publisher | Japanese Society for Joint Diseases 日本関節病学会 |
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| References | 4) Charnley, J.: Postoperative infection after total hip replacement with special reference to air contamination in the operating room. Clin. Orthop., 87: 167-187, 1972. 8) 今井亮, 榊田喜三郎, 山下文治, 他: 人工関節置換術の合併症. 整形外科, 33: 191-197, 1982. 6) 藤林英樹, 郷田秀樹, 前野耕作, 他: 重度リウマチ患者のリハビリテーションとfollow-up-理学療法を中心に-. 理学療法と作業療法, 11: 209-217, 1977. 7) Hunter, G., Dandy, D.: The natural history of the patient with an infected total hip replacement. J. Bone Joint Surge., 59-B: 293-297, 1977. 5) Clegg, J.: The result of the pseudarthhrosis after removal of an infected total hip prostesis. J. Bone Joint Surg., 59-B: 298-301, 1977. 11) 斉藤秀雄, 浅田莞爾, 桑原秀樹, 他: 感染症の既往を有する股関節に対する全人工股関節置換術. 整・災外, 27: 1183-1190, 1984. 2) 浅井富明, 長屋郁郎: 感染人工関節の傾向と対策. 整・災外, 30: 921-929, 1987. 10) Poss, R., Thornhill, T.S., Ewald, F.C. et al.: Factor influencing the incidence and outcome of infection following total joint arthroplasty. Clin. Orthop., 182: 117-126, 1984. 3) Buchholz, H.W., Elson, R.A., Engelbrecht, E. et al.: Management of deep infection of total hip replacement. J.Bone Joint Surg., 63-B: 342-353, 1981. 12) Turner, R. H., Miley, G.B., Fremont-Smith, P.: Septic total hip replacement and revision athroplasty. Revision Total Hip Arthroplasty (Turner, R.H., Scheller, A. D. ed) . p291-314, New York, Grune & Stratton, Inc. 1982. 1) Andrew, H.J., Arden, G.P., Hart, G.P. et al.: Deep infection after total hip replacement. J.Bone Joint Surg., 63-B: 53-57, 1981. 9) 西岡淳一, 七川歓次: 人工関節の感染症とその対策-二段階治療法-. 関節の外科, 10: 117-124, 1983. |
| References_xml | – reference: 4) Charnley, J.: Postoperative infection after total hip replacement with special reference to air contamination in the operating room. Clin. Orthop., 87: 167-187, 1972. – reference: 2) 浅井富明, 長屋郁郎: 感染人工関節の傾向と対策. 整・災外, 30: 921-929, 1987. – reference: 12) Turner, R. H., Miley, G.B., Fremont-Smith, P.: Septic total hip replacement and revision athroplasty. Revision Total Hip Arthroplasty (Turner, R.H., Scheller, A. D. ed) . p291-314, New York, Grune & Stratton, Inc. 1982. – reference: 11) 斉藤秀雄, 浅田莞爾, 桑原秀樹, 他: 感染症の既往を有する股関節に対する全人工股関節置換術. 整・災外, 27: 1183-1190, 1984. – reference: 6) 藤林英樹, 郷田秀樹, 前野耕作, 他: 重度リウマチ患者のリハビリテーションとfollow-up-理学療法を中心に-. 理学療法と作業療法, 11: 209-217, 1977. – reference: 7) Hunter, G., Dandy, D.: The natural history of the patient with an infected total hip replacement. J. Bone Joint Surge., 59-B: 293-297, 1977. – reference: 3) Buchholz, H.W., Elson, R.A., Engelbrecht, E. et al.: Management of deep infection of total hip replacement. J.Bone Joint Surg., 63-B: 342-353, 1981. – reference: 8) 今井亮, 榊田喜三郎, 山下文治, 他: 人工関節置換術の合併症. 整形外科, 33: 191-197, 1982. – reference: 1) Andrew, H.J., Arden, G.P., Hart, G.P. et al.: Deep infection after total hip replacement. J.Bone Joint Surg., 63-B: 53-57, 1981. – reference: 9) 西岡淳一, 七川歓次: 人工関節の感染症とその対策-二段階治療法-. 関節の外科, 10: 117-124, 1983. – reference: 5) Clegg, J.: The result of the pseudarthhrosis after removal of an infected total hip prostesis. J. Bone Joint Surg., 59-B: 298-301, 1977. – reference: 10) Poss, R., Thornhill, T.S., Ewald, F.C. et al.: Factor influencing the incidence and outcome of infection following total joint arthroplasty. Clin. Orthop., 182: 117-126, 1984. |
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| Title | Treatment of Deep Infection after Total Hip Replacement |
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