UNCEMENTED TOTAL ARTHROPLASTY IN OLD QUIESCENT INFECTION OF THE HIP

We reviewed the outcomes of 24 cases (24 patients) of uncemented total hip arthroplasty done to treat secondary osteoarthritis due to quiesc ent previous infection. There were 16 men and eight women aged from 24 to 78 years (mean, 50 yr). Eight patients had proven or probable tube rculous infection and the other 16 patients had a past history of sept ic hip. The patients were followed for between 2.5 and 7 years (mean, 4.5 yr). According to the Harris hip rating system, 18 of the patients had excellent or good results. Three patients had a preoperative eryt hrocyte sedimentation rate of 40 mm/h or higher and had a positive bac terial culture. Two of these patients developed reinfection. The other 21 patients had a preoperative erythrocyte sedimentation rate less th an 40 mm/h and no reinfection postoperatively. There were five complic ations other than infection: dislocation with ipsilateral femoral shaf t fracture, intraoperative femoral fracture, cup loosening, periprosth etic osteolysis, and nonunion of the greater trochanter. Uncemented to tal arthroplasty for old quiescent infection of the hip should be cons idered if the preoperative erythrocyte sedimentation rate is normal an d a course of prophylactic antituberculous therapy is given in patient s with an old tuberculous hip.