Femorotomy and cleaning for infected hip prostheses: 30 cases

Purpose We report infected hip prostheses treated by an original technique: frontal femorotomy after trochanterotomy. Material and methods This extensive technique enables perfect cleaning of t he femur and truly effective freshening of the endomedullar canal. We repor t 30 cases operated since 1991 use of femorotomy has been systematic from 1 995. Results We were able to reimplant 25 of these 30 hips. Our results after in fection were rather good with 4 recurrent infections in difficult cases (mu fti-operated patients and multiresistant germs in half of the cases). Fusio n of femorotomy was obtained in all cases. The mechanical outcome was not i mproved by femorotomy. The main problem was trochanter nonunion with 5 case s, all of them having had a trochanteromy during the first procedure. Discussion We use femorotomy as our routine technique for femoral cleaning in case of hip prosthesis infection. In less complicated cases, we do not r emove the trochanter from the femoral valve, limiting trochanteric complica tions, the main problem with this technique.