TOTAL HIP-REPLACEMENT AFTER RESECTION ART HROPLASTY

From 1976 to December 1994, a total of 347 patients underwent implanta tion of a hip prosthesis at the ENDO-Klinik for treatment of an unsati sfactory condition following resection arthroplasty. From 1976 to 1987 , 143 patients were treated and in 1989 the results obtained in these patients were analysed: 99 of them were available for a follow-up exam ination in 1989, and 64 for a further examination in 1995. In 130 case s infection had been the reason for joint resection. At the time of th e prosthesis operation (1-20 years later) intraoperative biopsy reveal ed that infection was still present in 41 cases (31.5 %). Only 15 of t hese infections had been detected preoperatively by joint aspiration. This shows that the value of resection arthroplasty as a method of tre ating periprosthetic infection is limited and lends support to the one -stage exchange operation, which is the method we prefer in cases of i nfected hip prostheses. The operative technique and preparation for im plantation of the prosthesis are described, as are septic and aseptic complications and the measures that can be taken to treat them. In spi te of the patients' generally poor initial condition and with due cons ideration for the further revision operations, the medium-term results finally obtained are poor in only 9 %.