Evaluation of ninety-six periprosthetic hip joint infections seen within five consecutive years


Periprosthetic infection ; hip infection ; prosthetic exchange ; prosthesis treatment algorithm

Published online: Sep 30 2018

Peter Larsson , Matthias Erschbamer , Christian Spross , Karl Grob , Bernhard Jost , Johannes Erhardt

From the Department of Orthopaedics and Traumatology, Kantonsspital St. Gallen, Switzerland


Periprosthetic hip joint infections (PHJI) are severe complications.

In 2003 Zimmerli published a well-noted treatment algorithm for PHJI. The aim of this study is to evaluate outcome, analyze the applied treatment regimen and compare it to the proposed algorithm. We evaluated the outcome of 96 PHJI treated at our institution between 2008 and 2012 and analysed adherence to the algorithm and outcome in coherence with the algorithm.

The operations performed were irrigation and debridement with exchange of mobile parts (45%), two-stage exchange (36%), one-stage exchange (12%) and permanent explantation (7%). 47% were acute infections, 53% were chronic. Staphylococcus aureus was the most common pathogen. The overall success rate was 88%. In 12% of the cases the chosen operation didn’t follow the algorithm. Of these only 10% was successfully treated with the primary operation.

We find that the algorithm proposed by Zimmerli is a useful tool and easy to translate into clinical practice. When followed it yields a high success rate.