A Midterm Analysis of Outcomes of Septic Arthritis of Hip Treated With Two Stage Cement Spacer and Total Hip Arthroplasty.

Objectives: Septic arthritis of the hip, if not managed early and adequately, leads to degenerative arthritis with pain and debility. Various treatment options have been recommended, but no guidelines for the same have been established. Aim of the study is to evaluate the efficacy of our protocol for timing of staging using serological markers, rate of periprosthetic joint infection, midterm implant survivorship and functional outcomes.

Methods: Thirteen patients aged 25 years and above, suffering from degenerative hip arthritis secondary to septic hip, were treated with 2 stage total hip replacement according to our protocol and serological markers were assessed for the timing of stages and follow up of infection control. Outcome of success of two stage total hip arthroplasty was assessed using modified Delphi criteria.

Results: Both the acetabulum and femur head were involved in all cases. Two patients had a history of previous hip surgery. The most common micro-organism detected in intraoperative cultures was Staphylococcus aureus. The mean Harris Hip Score at the final follow-up was 82.33. The outcome was deemed excellent in 84.6 % and good in 15.4 % of cases.

Conclusion: Septic arthritis of the hip leading to end stage degenerative joint disease can be effectively managed with two stage total hip arthroplasty with good to excellent clinical and functional results.