Janz V, Wassilew GI, Perka CF, Müller M. Cerclages after Femoral Osteotomy Are at Risk for Bacterial Colonization during Two-Stage Septic Total Hip Arthroplasty Revision.
J Bone Jt Infect 2018;
3:138-142. [PMID:
30013895 PMCID:
PMC6043469 DOI:
10.7150/jbji.24819]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 04/05/2018] [Indexed: 12/19/2022] Open
Abstract
Aims: In cases of a two-stage septic total hip arthroplasty (THA) exchange a femoral osteotomy with subsequent cerclage stabilization may be necessary to remove a well-fixed stem. This study aims to investigate the rate of bacterial colonization and risk of infection persistence associated with in situ cerclage hardware in two-stage septic THA exchange.
Patients and Methods: Twenty-three patients undergoing two-stage THA exchange between 2011 and 2016 were included in this retrospective cohort study. During the re-implantation procedure synovial fluid, periprosthetic tissue samples and sonicate fluid cultures (SFC) of the cerclage hardware were acquired.
Results: Seven of 23 (30%) cerclage-SFC produced a positive bacterial isolation. Six of the seven positive cerclage-SFC were acquired during THA re-implantation.
Two of the seven patients (29%) with a positive bacterial isolation from the cerclage hardware underwent a THA-revision for septic complications. The other five patients had their THA in situ at last follow-up.
Conclusions: Despite surgical debridement and antimicrobial therapy, a bacterial colonization of cerclage hardware occurs and poses a risk for infection persistence. All cerclage hardware should be removed or exchanged during THA reimplantation.
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