Early periprosthetic hip joint infection managed by cementless one-stage revision – a case series

Abstract

<b>Background</b>: Early periprosthetic hip joint infection (PJI) is traditionally treated with debridement, antibiotics, and implant retention (DAIR). However, infection control rates after DAIR-treated periprosthetic hip joint infection do not exceed 77 %. Cementless one-stage revision of chronic PJI by the Cementless One-stage Revision of Infected Hip Arthroplasty (CORIHA) protocol has been evaluated positively with a 91 % success rate. We wanted to evaluate the effectiveness of cementless one-stage revision following the CORIHA protocol for early PJI in elective primary total hip arthroplasty, regarding risk of re-operation with exchange of implants. <b>Methods</b>: We identified 18 patients in our center with early ( <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mrow><mml:mo>≤</mml:mo> <mml:mn>6</mml:mn></mml:mrow> </mml:math> -week postoperative) PJI after primary total hip arthroplasty (THA) treated with one-stage cementless revision in the period January 2012-March 2018. Treatment followed the CORIHA protocol. Primary outcome was retention of implants at the most recent follow-up. Patients were followed for a minimum of 3 years. <b>Results</b>: Mean follow-up time was 60 months (39-105). All patients retained their implants, but two required superficial soft tissue debridement due to persistent wound seepage. <b>Conclusion</b>: Cementless one-stage revision appears to be an effective treatment of early PJI after primary THA and at least an equal choice of treatment compared with DAIR. Whether the potential benefit of a lower re-revision rate for postoperative PJI outweighs the increased surgical complexity of the CORIHA procedure needs further evaluation.