Septic complications of hip arthroplasty

Abstract

Introduction: Septic complications of hip arthroplasty present a complication that can be more critical than an infection. The incidence of this complications in Republic of Moldova is approximately 1-2 %. Aim: We report 20 cases of infected hip arthroplasty. Methods: This is a prospective and retrospective primary analysis of 20 patients, which were surgery-treated with hip arthroplasty in National Centre of Emergency Medicine, Chisinau, Moldova. Result: The age of the patients were between 63-81 years. All the patients were assigned depending on the type of prosthesis: 6 of them had hip cemented prosthesis, 12 of them had noncemented prosthesis and 2 of them had cervicocefalic prosthesis. Depending on the detection of infection was find: acute infection 6 cases (first 4 weeks); chronic infection 11 cases (4 weeks) and 3 cases detected intraoperatively. Depending on the pathogen agent, in patients with acute infection was present: 3 cases Staphylococcus Aureus, 1 case of E. coli and 2 cases of P. aeruginosa. The treatment of patients with acute infections was: antibacterial therapy according to preoperative antibiogram, debridement and lavage, maintaining the implant and postoperative treatment for 6 weeks.The treatment of patients with chronic infection was: revision, debridement, lavage, removal of prosthetic components and antibiotic cement spacer and after 6 months-arthroplasty. Conclusion: The treatment in septic complications of hip arthroplasty depends on the general condition of the patient (age, comorbidity, immune response), the chronicity of infection and the bacterial sensibility. Revision is the best solution to chronic infections with the use of an antibiotic cement spacer. Early diagnosis allows to make the best treatment.