One-stage Revision And Two-stage Revision Operations To Postoperative Infection After Hip Arthroplasty

Purposes:To disscuss the effects of one-stage revision and two-stage revision to postoperative infection after hip arthroplasty and compare the results.Methods:From February 2000 to January 2009,63 cases of infection after hip arthroplasty were treated, including 39 males and 24 females, with a mean age of 56.9 years(40—81 years). Abnomal erythrocyte sedimentation rate(ESR) were observed in 48 cases and the increased C-reactive protein(CRP) in 48 patients.The X—ray films showed that periosteal reaction, osteolysis and loosening of prosthesis occurred. The results of bacterial culture were positive in 49 cases. One-stage revision was performed in 23 cases, two-stage revision was performed in 40 cases.Results:The microorganism cultures results of secrata of fistula preoperatively and intraoperative tissue were positive in 49 cases; 28 had staphylococcus epidermids infection,and 11 staphylococcus aureus infection. Postoperative recurrent infection was found in 6 cases with the mean follow-up of 40 months. The mean Harris score increased significantly to 91(15—99)after revision, showing significant difference when compared with that before operation(p<0.01).Conclusion:1.The main microorganism of postoperative infection after hip arthroplasty is staphylococcus epidermids and staphylococcus aureus.2.For postoperative infection after total hip arthroplasty, it is still possible to have satisfactory clinical outcome by one-stage or two-stage revision as long as clear diaglosis and correct treatment can made.3.The two-stage revision has a higher eradication rate of infection than one-stage revision in the treatment of infected hip arthroplasty.