Infected Total Hip Arthroplasty: Diagnosis and Treatment

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Abstract
Tic. New immunologic techniques may allow differentiation of aseptic loosening from septic loosening of a painful total hip arthroplasty. Once the diagnosis of a deep infection about a total hip arthroplasty has been established, there are several treatment options. Oral antimicrobial therapy combining rifampin with a fluoroquinolone may prove to be an attractive alternative to surgical intervention in the treatment of some staphylococcal infections. If the causal microorganism is considered to be less virulent and does not elaborate glycocalyx, a one-stage procedure for reconstructing the hip with a cemented total hip arthroplasty incorporating antibiotics that are cidal to the microorganism has been successful in as many as 90% of patients. If the causal microorganism is considered to be virulent, a two-stage procedure with a prolonged interval between the Girdlestone resection arthroplasty and the second-stage reconstructive procedure is the treatment of choice....