PREOPERATIVE KNOWLEDGE OF THE CAUSAL GERM AND ONE- OR TWO-STAGE HIP PROSTHESIS REPLACEMENT

Purpose: We reviewed retrospectively 349 cases of infected total hip arthroplasty treated by prosthesis replacement. The surgical strategy, 127 single-stage procedures and 222 two-stage procedures, was determined by the surgeon on a case by case basis.Material and methods: At least one positive sample during the clinical history was required for inclusion in the series. Results of all bacteriological samples collected pre- and intra-operatively were noted. Samples were considered reliable if obtained from a deep site (puncture, biopsy, intraoperative specimen) and non-reliable if obtained from any other site. We studied the agreement between preoperative and intraoperative samples, taking the intraoperative samples as the reference, in order to determine the effect of complete preoperative knowledge of the causal germ on the outcome of infection treatment at last follow-up.Results: For single-stage replacement procedures, preoperative samples were reliable in 74 cases (58%) and non reliable in seven (6%);...