Deep infection after total hip arthroplasty is one of the most serious post operative complications. Treatment of infection of the hip joint can be made very difficult by poor response to antibiotic therapy. Infection rates of total hip arthroplasty have decreased due to prophylactic antibiotics, sterilization of surgical instruments, cleaner operation environments, Improvement of surgical methods and proper patient selection. Recently, post operative infection rates of primary or revision arthroplasties were reported to still be as high as 1% to 2%. Therefore, the aim of this article is to review the recent literature and to evaluate the cause, environment diagnosis and treatment of infection after total hip arthroplasty.

Trochanteroplasty is a salvage procedure that is normally performed in septic infant hips. The procedure can provide a stable, painless, functional hip, and reduce any leg-length discrepancy. The authors describe a case of revisional total hip arthopalsty performed on a 65 year-old male patient 4 years after trochanteroplasty for an uncontrolled infection after total hip arthoplasty. The available literature on trochanteroplasty was reviewed. The authors provide a feasible strategy for treating adult hip infections with deficient bone stock in the proximal femur.

Purpose: To analyze the effectiveness of a two-stage revision surgery for an infected total hip arthroplasty.
Materials and Methods: Between 1988 and 2005, twenty-four patients (24 hips, 18 males, 6 females) with documented infection of total hip arthroplasty were reviewed and followed for at least two years postoperatively. The preoperative and postoperative clinical and radiologic findings and blood laboratory work were compared. Eight arthroplasty cases were performed through retention of the femoral stem and removal of the acetabular cup with cementing by impregnated antibiotics in the first stage of the operation, and subsequent acetabular cup revision in the second stage of the operation.
Results: After the first stage of the operation, infectious organisms were cultured in 19 patients, and isolated Staphylococcus aureus was cultured in 14 patients. The mean follow-up period was 8.2 years, and the average Harris hip score improved to 88.4 points at last follow-up. Radiologic osteolysis was noted in 5 cases, and possible loosening was demonstrated in 1 case. The erythrocyte sediment rate (mm/hr) and C-reactive protein (mg/L) were 43.8/14.2 preoperatively and 17.9/8.3 postoperatively. There were 2 recurrences of infection, for an eradication rate of 91.7% (22 of 24).
Conclusion: Two-stage revision for an infected total hip arthroplasty proved to be an excellent method with a high eradication rate.