Infection after Total Hip Arthroplasty for Rheumatoid Arthritis.

概要

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This study was done to evaluate the long-term outcome of total hip arthroplasty (THA) for rheumatoid arthritis (RA) at the Senami RA center and to discuss the management of infection following THA. Infections occurred in 6 hips (2.8%) out of 212 THAs in RA patients during a 15-year period. Two resulted in an early-onset infection within 1 year after operation and 4 resulted in late-onset infection after more than 1 year. Initially, each case was treated with antibiotics and local debridement, however, in 5 cases the prostheses finally had to be removed. After removal, 2 cases were diagnosed as so-called "Girdle stone, " 2 underwent revision, and one case died because of sepsis. There was no recurrence of infection in any of these cases.<BR>Although, intraoperatively, a sterile procedure is very important in the prevention of postoperative infection, especially in RA patients, preexisting infections should be treated pre-and postoperatively, because host susceptibility to infection increases dramatically. At our center, specific attention has been given to predisposing conditions, such as diabetes mellitus, renal insufficiency, skin ulcers, and ingrown toe nails, etc., so there have been no infections at the center since 1989.
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