EXPERIENCE OF TREATMENT OF INFECTIOUS COMPLICATIONS AFTER PRIMARY HIP JOINT ENDOPROSTHESIS REPLACEMENT

Abstract

Aim. The aim of the study was to analyze the results of treatment of infectious complications after primary hip joint endoprosthesis replacement. Materials and methods. The results of treatment conducted in 735 patients after primary hip joint endoprosthesis replacement were analyzed. Clinical, roentgenological, laboratory and bacteriological methods of study were used. Results. Development of paraprosthetic infection is a severe complication after primary hip joint endoprosthesis replacement. Complications connected with paraprosthetic infection were found in 8 (1 %) patients. The early postoperative infectious complications developed in the terms up to 4 weeks - in 3 patients, from 4 weeks to 6 months - in 2 patients. The late postoperative infectious complications (more than 1 year) were stated in 3 patients. In 6 patients the infectious agent was revealed - it was St. Aureus ; in 1 patient it was Ps. Aeruginosa ; in 1 patient infectious agent was not identified. Three patients with developing paraprosthetic infection in the early postoperative period (up to 4 weeks) underwent debridment (sanation) of the joint using washing system and antibacterial therapy course. Conclusions. 1. The paraprosthetic infection development rate in primary hip joint endoprosthesis replacement is 1 %. 2. Efficiency of surgical treatment of paraprosthetic infection is determined by the quality of joint debridment performed, irrespective of the terms of development of this infection.

Keywords

Hip joint endoprosthesis replacement / infectious complications / treatment

References

[1] Горидова Л.Д. Бактериальные артриты крупных суставов (этиопатогенез, диагностика, лечение): дис. … д-ра мед. наук. Харьков 1994; 310.

[2] Горидова Л.Д., Филиппенко В.А., Вырва О.Е., Романенко К.К. Септические артриты тазобедренного сустава. Травма 2004; 1: 70-75.

[3] Дзюба Г.Г., Резник Л.Б. Современные подходы к выполнению первого этапа ревизионного эндопротезирования тазобедренного сустава при поздних инфекционных осложнениях. Травматология и ортопедия России 2009; 3: 127-129.

[4] Зубрицкий В.Ф., Козлов Ю.А. Инфекционные осложнения в эндопротезировании крупных суставов. Вестник Национального медико-хирургического центра им. Н.И. Пирогова 2012; 1: 98-103.

[5] Hsieh P.N., Lee M.S., Hsu K.Y., Chang Y.H. Gram-negative prosthetic joint infection: risk factors and outcome of treatment. Clin. Infect. Dis. 2009; 7: 1036-1043.

[6] Love C., Palestro C.J. Radionuclide imaging of infection. J. Nucl. Med. Technol. 2004; 2: 47-57.

[7] Martines-Pastor J.C., Munos-Mahamud E., Vilchez F., Garcia-Ramiro S. Outcome of acute prosthetic joint infections due to gram-negative bacilli treated with open debridement and retention of the prosthesis. Antimicrob. Agents Chemother. 2009; 11: 4772-4777.

[8] Phillips C.B., Barret J.A., Losina E. Incidence rate of dislocation, pulmonary embolism, and deep infection during the first six month after elective hip replacement. J. Bone. Jt. Surg. 2003; 20: 6.

[9] Salvati E.A., Gonzales Della Valle A., Masri B.A., Duncan C.P. Instr. Course. Lect. 2003; 52: 223.

[10] Tentino J.R. Prosthetic joint infection: bane of orthopedist, challenge for infectious disease specialists. Clin. Infect. Dis. 2003; 1157: 61.

[11] Trampuz A., Osmon D.R., Hanssen A.D., Steckelberg J.M., Patel R. Molecular and antibiofilm approaches to prosthetic joint infection. Clin. Orthop. 2003; 414: 69-88.

RIGHTS & PERMISSIONS

Tikhomirov D.A., Schekolova N.B.