Grupo GRECARO.
Servicio de Ortopedia y Traumatología del Hospital Británico de Bs As. Buenos Aires, Argentina.
Acta Ortop Mex. 2021 Jan-Feb;35(1):11-16.
The most feared complication in hip arthroplasty after septic arthritis is septic failure. It is considered that the two-stage treatment is the accepted treatment for acute septic hip arthritis. The objective in this work is to establish a therapeutic guideline for septic arthritis in native hips, proposing a two-stage treatment for acute, and a one-stage treatment for quiescent.
Observational, descriptive, retrospective study. We analyzed all patients who underwent total primary hip replacement between June 1997 and June 2016. We selected those patients who had a diagnosis of septic arthritis of the hip prior to surgery (group 1: acute septic arthritis; group 2: quiescent septic arthritis).
Eight hips in group 1 with a follow-up of one to six years. Each patient fulfilled the antibiotic treatment between the placement of the spacer and the definitive prosthetic replacement, and, in all the cases, the remission of the infection was verified. On the other hand, 12 hips in group 2, the time between the treated infection and the prosthetic replacement varied between five and 46 years. The femoral heads sent to culture were in all cases negative.
In the last 20 years, we have obtained satisfactory results, both in the treatment of acute septic arthritis and in its sequelae, interpreting them as pathologies of the same origin but with a different treatment. Both treatments are adequate, as long as the therapeutic protocol established for each of the groups is respected.
髋关节置换术后最令人恐惧的并发症是感染性失败。人们认为，两阶段治疗是急性感染性髋关节炎的公认治疗方法。本研究旨在为原发性髋关节感染性关节炎建立治疗指南，提出急性感染性关节炎采用两阶段治疗，慢性感染性关节炎采用一阶段治疗。
观察性、描述性、回顾性研究。我们分析了 1997 年 6 月至 2016 年 6 月期间所有接受初次全髋关节置换术的患者。我们选择了术前诊断为髋关节感染性关节炎的患者（第 1 组：急性感染性关节炎；第 2 组：慢性感染性关节炎）。
第 1 组 8 髋，随访 1 至 6 年。每位患者在放置间隔器和最终假体置换之间都接受了抗生素治疗，所有患者的感染均得到缓解。另一方面，第 2 组 12 髋，从感染治疗到假体置换的时间在 5 至 46 年之间不等。送检的股骨头培养均为阴性。
在过去 20 年中，我们在急性感染性关节炎及其后遗症的治疗中取得了满意的效果，将其视为同一来源的不同疾病，但治疗方法不同。只要遵守每个组制定的治疗方案，两种治疗方法都是有效的。
