Total hip infections

The low-friction total hip arthroplasty (THA) has revolutionized care of the arthritic hip. The extensive need for this procedure coupled with a high degree of patient satisfaction and excellent longevity made THA one of the most significant contributions in orthopedic surgery in the 20th century. Despite the evolution of knowledge and technology gained over the last 40 years, infection of the periprosthetic environment continues to be a formidable complication of this procedure. Considerable strides have been achieved as the incidence of this complication has declined significantly from the 9% reported in Sir John Charnley’s initial experience (1) to the current incidence of 1%-2% (2-4). A variety of prophylactic techniques have been investigated in an effort to decrease this incidence even further. If a periprosthetic infection is suspected, many investigative modalities that aid in confirming the diagnosis are available. With the knowledge of the established indications for the various treatment methods available, the treating surgeon can select the most appropriate course of action and optimize the patient’s chance for successful eradication of the infection.