Abstract
I wish to present my experience with 521 patients with infection around hip arthroplasty and 262 with infected knee arthroplasty. The management in each case depends on circumstances such as the period since surgery, the patient’s symptoms, severity of illness and general health, and the condition of the remaining bone stock.
One hundred and thirty hips and 94 knees were managed conservatively i.e. without surgery.
Nine knees and 11 hips had debridement and irrigation without removing the arthroplasty. Infection persisted in 2 knees and 3 hips.
Nine knees were exchanged in one stage. infection persisted in 5. Forty three hips were exchanged in one stage. Infection persisted in 18.
Fifty knees were exchanged in two stages. Infection persisted in 11. One hundred and ninety eight hips were exchanged in two stages. Infection persisted in 28.
Arthrodesis was performed in 77 of the more severely infected and destroyed knees. Infection persisted in 32.
One hundred and eight of the more severely destroyed hips were left as excision arthroplasties. Ten remained infected but comfortable.
Five patients required amputation above the knee and three through the hip.
Two patients sustained serious vascular complications during surgery at the hip and one at the knee.
Four patients in this series died during treatment
Correspondence should be addressed to Vienna Medical Academy, Alser Strasse 4, A-1090 Vienna, Austria. Phone: +43 1 4051383 0, Fax: +43 1 4078274, Email: ebjis2009@medacad.org
