Infection in total hip replacement: meta-analysis

Int Orthop. 2011 Feb;35(2):253-60. doi: 10.1007/s00264-010-1144-z. Epub 2010 Nov 18.

Abstract

While total hip arthroplasty has progressed to become one of the most successful surgical procedures ever developed, infection remains a serious complication. We have conducted a review of the literature pertaining to management of deep infection in total hip arthroplasty, specifically focusing on clinically relevant articles published in the last five years. A search was conducted using MEDLINE and PubMed, as well as a review of the Cochrane database, using the terms "total hip arthroplasty", "total hip replacement" and "infection". References for all selected articles were cross-checked. While the so-called two-stage revision is generally considered to be the gold standard for management, numerous studies now report outcomes for implant retention and reassessing one-stage revision strategies. There are encouraging reports for complex reconstruction options in patients with associated severe bone stock loss. The duration of antibiotic therapy remains controversial. There is concern about increasing bacterial resistance especially with the widespread use of vancomycin and ertapenem (carbapenem).

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Arthroplasty, Replacement, Hip / methods
  • Bacterial Infections / etiology*
  • Bacterial Infections / microbiology
  • Bacterial Infections / therapy
  • Databases, Bibliographic
  • Debridement
  • Hip Joint / microbiology
  • Hip Joint / surgery
  • Hip Prosthesis / adverse effects*
  • Humans
  • Prosthesis-Related Infections / etiology*
  • Prosthesis-Related Infections / microbiology
  • Prosthesis-Related Infections / therapy
  • Reoperation
  • Surgical Wound Infection / etiology*
  • Surgical Wound Infection / microbiology
  • Surgical Wound Infection / therapy

Substances

  • Anti-Bacterial Agents