OUTCOME AFTER REINFECTION FOLLOWING REIMPLANTATION HIP-ARTHROPLASTY

Between 1976 and 1992, reinfection developed in 34 patients treated fo r an infected total hip arthroplasty with removal of the prosthesis an d implantation of another prosthesis, These patients included 15 men a nd 19 women with a mean age of 62 years, Infection recurred an average of 2.2 gears after reimplantation of the new prosthesis, Followup aft er the diagnosis of reinfection averaged 5.1 years, Reinfection after an attempt at reimplantation total hip arthroplasty was seldom compati ble with a good functional outcome, Resection arthroplasty was reliabl e in eradicating reinfection but led to poor function and was associat ed with persistent pain, Although reimplantation of a third prosthesis allowed 3 patients to achieve an excellent result, the 8 hips that fa iled a third reimplantation attempt had the worst functional results i n this study, The results from the present series suggest that reinfec tion after an attempt at reimplantation is a contraindication to furth er attempts at a 1-stage reimplantation of another prosthesis, Those p atients in whom the same single microorganism has been identified from the failed primary total hip and from the failed first reimplantation , however, may be reasonable candidates for an attempt at a 2-stage re implantation of a third prosthesis, particularly when a deficiency in prior antibiotic therapy or surgical technique can be identified.