Deep wound sepsis following total hip arthroplasty

TLDR

All procedures were performed in conventional operating rooms. Among 2,694 patients who received 3,215 total hip arthroplasties, deep wound infection occurred in 42 hips (1.3 %) over 2–5 years, most arising immediately post‑op or up to five years later; risk factors were prior surgery, prolonged operative time, positive intra‑operative cultures, and undiagnosed pre‑operative sepsis, and only eight of the 41 affected patients had salvageable prostheses, with three deaths directly attributable to the infection or its treatment.

Abstract

After follow-ups ranging from two to five years on all but four (five hips) of 2,694 patients who had 3,215 total hip arthroplasties, deep wound infection had been demonstrated in forty-two hips (1.3 per cent). The infections among the 3,210 hips appeared during the immediate postoperative period or as long as five years after surgery. All operations were performed in conventional operating rooms. Previous operations, prolonged operating time, positive culture at operation, and unrecognized preoperative sepsis were related to the development of deep infection. In only eight of the forty-one patients (forty-two hips) was salvage of the prosthetic arthroplasty possible. The deaths of tree patients were directly attributable to the infection or its treatment.