Despite the assumption of Fehring and colleagues, we could observe in our collective a prosthesis dislocation in 23 % of the cases. We believe that this high dislocation rate after prosthesis reimplantation can be explained by following thesis: every surgical procedure causes trauma to the local tissues, leading to muscle and bone loss. Proper debridement of the infected hip requires often debridement of bone. Bone loss makes proper component position difficult, leading to potential malposition and increasing the risk of instability. Multiple surgical revisions also increase the risk of developing abductor dysfunction. As the abductors become less functional, their important role in hip stability is lost. We believe this is a very important topic, and patients undergoing a two-stage protocol in the treatment of hip joint infection should be preoperatively informed about it, especially those having already undergone surgical revisions for infection management. Perhaps, it would be advisable to use constrained acetabular components in these cases.
33. Takahira N, Itoman M, Higashi K, Utsiyama K, Miyabe M, Naruse K. Treatment outcome of two-stage revision total hip arthroplasty for infected hip arthroplasty using antibiotic-impregnated cement spacer. 2003;8:26-31
Preventing acute infection in total hip ..
Since each failed hip replacement has a different reason for its failure, preparing for the revision hip replacement is also going to be unique. Specialized CAT scans or MRI tests may be needed to evaluate bone loss around the current implant or position of the prosthesis relative to the normal anatomy. Various laboratory or nuclear scans to check for infection may be indicated such as CBC, CRP, Sed. Rate or Bone Scan. An aspiration of the hip joint may yield fluid that can be analyzed by cell count and culture. Finally, consultations with other medical or surgical specialists may be required to evaluate the medical condition or special circumstances of the patient prior to surgery to optimize the outcome.
Removal of Hip Prosthesis - Medical Auditing - AAPC
Regarding the femoral fixation of hip spacers, there exist to our knowledge 3 methods: i) press-fit, ii) partially or totally cementation, and iii) the “glove“ - technique . The latter technique has been recently described and provides a stable fixation onto the proximal femur at facilitating the spacer's explantation since the spacer can be removed at one piece and there is no need for removal of any cement debris compared with other normal cementation techniques. However, it is unclear, which of the above mentioned techniques is the most superior one in the prevention of spacers' dislocations regarding the femoral part.
Hip replacement infection common cold - HealthTap
8. Siqueira MBP, Saleh A, Klika AK. . Chronic suppression of periprosthetic joint infections with oral antibiotics increases infection-free survivorship. 2015;97:1220-32
Diagnosis of infection following total hip arthroplasty.
4. Kunutsor SK, Whitehouse MR, Lenguerrand E. . Re-infection outcomes following one- and two-stage surgical revision of infected knee prosthesis: a systematic review and meta-analysis. 2016;11(3):1-15
Possible Complications After Hip Surgery — Mr Evert …
3. Kunutsor SK, Whitehouse MR, Blom AW. . Re-infection outcomes following one- and two-stage surgical revision of infected hip prosthesis: a systematic review and meta-analysis. 2015;10(9):3-14
Revision Hip Replacement - Zehr Center Orthopaedics
1. Lange J, Troelsen A, Thomsen RW. . Chronic infections in hip arthroplasties: comparing risk of reinfection following one-stage and two-stage revision: a systematic review and meta-analysis. 2012;4:57-73