Irrigation and debridement for periprosthetic hip infections: A systematic review

Abstract

We performed a systematic review of the literature regarding outcomes of early infection after total hip arthroplasty (THA). We searched multiple databases (PubMed, Web of Science, EMBASE, and Cochrane library) for articles in the area published from 1950 to 2016.

A total of 212 patients from 8 published studies were identified. The minimum follow-up was 4 months (range, 4–132 months). The most frequently isolated organisms were Staphylococcus aureus and coagulase-negative staphylococci. 153 of 212 (72%) patients were successfully treated, with no signs of infection or continued antibiotic treatment at the latest follow-up. In 48 of the 59 patients for whom treatment failed, infection was successfully treated with 1-stage
or 2-stage reimplantation or resection arthroplasty. Overall mortality attributable to the infection of the hip was 2 % (four patients).

Our study has helped to further elucidate the clinical and functional outcome of early periprosthetic hip infections treated with debridement, antibiotics and implant retention. We believe DAIR is a reasonable treatment option in early infection after primary THA in selected patients.