A Two Phase Treatment of an Infected Hip Endoprosthesis

The revision of the two phase treatment represents a golden standard in the treatment of infected endoprosthesis. Throughout this study, the results of 21 patients with an infected hip endoprosthesis treated in two phases have been processed, with the use of an antibiotic spacer, within the period o...

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Bibliographic Details
Published in:	Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki) Vol. 36; no. 2; p. 195
Main Authors:	Ciriviri, Jasmin, Talevski, Darko, Nestorovski, Zoran, Vraniskoski, Tode, Mishevska-Perchinkova, Snežana
Format:	Journal Article
Language:	English
Published:	Macedonia 2015
Subjects:	Adult Aged Anti-Bacterial Agents - administration & dosage Arthroplasty, Replacement, Hip - adverse effects Arthroplasty, Replacement, Hip - instrumentation Coated Materials, Biocompatible Debridement - adverse effects Device Removal - adverse effects Drug Administration Schedule Female Hip Joint - pathology Hip Joint - physiopathology Hip Joint - surgery Hip Prosthesis - adverse effects Humans Male Middle Aged Necrosis Prosthesis Design Prosthesis-Related Infections - diagnosis Prosthesis-Related Infections - microbiology Prosthesis-Related Infections - surgery Reoperation Time Factors Treatment Outcome
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Summary:	The revision of the two phase treatment represents a golden standard in the treatment of infected endoprosthesis. Throughout this study, the results of 21 patients with an infected hip endoprosthesis treated in two phases have been processed, with the use of an antibiotic spacer, within the period of 2009 and 2012. Thereby, a unique protocol for diagnosis and treatment of infections has been applied to all the patients, which entails a preoperational x-ray image, laboratory findings (Se, CRP), as well as a puncture aspiration with a microbiological and biochemical examination of the aspirated fragments. The operational treatment consists of: taking a sample for microbiological and histopathological diagnosis, removal of the implanted endoprosthesis, excision of the avascular and necrotic tissue and installing an antibiotic spacer. Postoperatively, the patients are treated with a parenteral application of an antibiotics based on an antibiogram, throughout a period of two weeks, and later on an oral treatment, a combination of two antibiotics, depending on the antibiogram, within the following four to six weeks. After the appeasement of the local findings and the laboratory results, a revision with a removal of the antibiotic spacer and reimplantation of an endoprosthesis - revisional or primary has been conducted on the patients, depending on the bone deficit. The functionality of the joint is graded based on the Haris Hip Score. The patients are being observed postoperatively for a period of 12 to 36 months. A definite reimplantation has been applied to 20 patients, while one patient has been treated with a resection method. The Haris Hip Score was 45 preoperatively, and 80 postoperatively. The applied protocol of the treatment of infected endoprosthesis is effective in the eradication of the infection and the final reimplantation.
ISSN:	1857-9345 1857-9345
DOI:	10.1515/prilozi-2015-0067