| Object: Infection associated with prosthetic joints is a serious complication of total hip arthroplasty. The rate of infections has decreased from 7-10% to 0.5% due to the improvement of technology's progress, but it was still unable to eliminate completely. Once occurs, the result will be deeply grieved. This article mainly discussed the infects diagnosis, clinical manifestation, treatment methods and treatment effect of postoperative infection after total hip arthroplasty and through the analysis of experimental research, comprehensive analysis of the selection of treatment and prognosis of influence various factors. This will help us to prevent infection scientifically and provide scientific basis for the solution of the infection.Methods: In this article, we retrospected and followed up 12 cases of postoperative infection after total hip arthroplasty from July in 2007 to March in 2010, which were underwent operation and antibiotic treatment in China-Japan union hospital of JiLin university. We compared the preoperative white blood cell count, erythrocyte sedimentation rate(ESR), C-reactive protein and the joint function with the postoperative results and also did an experiment, which we made zeolite coating on Ti alloy surface by using an in situ hydrothermal crystallization method and then used the ion exchange method to make silver ion into the Ti alloy. Then, we did a in vitro antimicrobial test to analyse the antibacterial ability of the material.Results:1. The ESR,the CRP and WBC values were 53.56±11.91 mm/h,26.20±10.35mg/L and 10.94±3.15x109/L in the patients with infecter prostheses, while after the revision surgery, the values reduced to 23.56±6.02mm/h,5.95±1.23mg/L and 6.8±1.61 x109/L. 2. The preoperative hip tissue cultures were positive in 3 patients and negative in 9 patients, the bacteria related to infection was Staphylococcus. The surgical pathology examinations were all positive in 12 patients. 3. One made an unsuccessful routine vancomycin continued therapy. Of the eleven patients with infected prosthesis, five underwent one-stage revision, six underwent two-stage revision. The preoperative Harris hip score was 40±7 compared to 74±8 after the operations. 4. In twelve cases, four had diabets, two had used hormone, five were 60 years old, two often had urinary tract infection. 5. In order to confirm the antibacterial effect against drug-resistant bacteria, multiresistant S.aureus and P.aeruginosa were selected. The bacteriostasis rate to S.aureus in silver-exchanged group: 4h was 0.8828±0.0277, 8h was 0.9952±0.0026, 12h was 0.9994±0.0002, 24h was 0.9981±0.0008. The bacteriostasis rate to P.aeruginosa in silver-exchanged group: 2h was 0.9042±0.0084, 4h was 0.5314±0.0302, 8h was 0.9992±0.0003, 12h was 0.9999±0.0000, 24h was 0.9999±0.0000. The result of viable S.aureus and P.aeruginosa adhered on different surfaces(Ti,zeolite,Ag) after 3-hour incubation were 8100±900,620±62,150±30 and 19867±907,125300±37067,0。Conclusion: 1. It should be highly suspected infections that ESR,CRP and WBC are continuous high value after total hip arthroplasty. 2. Through reducing the preoperative risk factors and adopting rational preventive measures, the rate of infection after total hip arthroplasty can be reduced. 3. It can diagnose the types of infection by the ways of taking tissues around the prosthesis to culture or pathology exam. 4. One-stage or two-stage revision with appropriate antibiotics has achieved a good success rate. These results are successful in terms of funtion and not just eradication of sepsis. 5. The experiment results show silver exchanged zeolite coating on Ti alloy can effectively reduce the number of bacteria both in suspension surrounding the materials and on material surfaces, it provide us a good research foundation to invent new prosthesis.
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