Tài liệu Báo cáo y học: " Rationale for one stage exchange of infected hip replacement using uncemented impla

Infection of a total hip replacement (THR) is considered a devastating complication. Due to the absence of well-designed prospective, randomised, controlled studies with a sufficient follow-up period, diagnosis and treatment of prosthetic joint infections is mainly based on tradition, personal experience and liability aspects. It is generally accepted, that implants and necrotic tissue are covered with bacterial colonies that show inherent resistance to both host defence mechanisms and antimicrobial chemotherapy making the treatment extremely difficult. Uncertainty on the most effective approach has lead to several suggestions for treatment. Surgical debridement with implant retention is limited to very selected cases; most authors consider thorough removal of all implants and necrotic tissue a prerequisite for cure.