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The use of two-stage exchange arthroplasty with depot antibiotics in the absence of long-term antibiotic therapy in infected total hip replacement

¹ Sheffield Teaching Hospitals Trust, Herries Road, Sheffield, S5 7AU, UK.
² Wrightington Hospital, Hall Lane, Appley Bridge, Wigan WN6 9EP, UK.

Correspondence should be sent to Mr. I. Stockley; e-mail: Ian.Stockley{at}sth.nhs.uk

We present a series of 114 patients with microbiologically-proven chronically-infected total hip replacement, treated between 1991 and 2004 by a two-stage exchange procedure with antibiotic-loaded cement, but without the use of a prolonged course of antibiotic therapy. The mean follow-up for all patients was 74 months (2 to 175) with all surviving patients having a minimum follow-up of two years. Infection was successfully eradicated in 100 patients (87.7%), a rate which is similar to that reported by others, but where prolonged adjuvant antibiotic therapy has been used. Using the technique described, a prolonged course of systemic antibiotics does not appear to be essential and the high cost of the administration of antibiotics can be avoided.