Irrigation and debridement for periprosthetic infections of the hip and factors determining outcome

Purpose Our purpose was to identify the success rate and factors predicting outcome of irrigation and debridement (I&D) in patients with deep periprosthetic joint infection (PJI) of the hip. Methods We retrospectively reviewed clinical characteristics of patients with deep PJI after primary/revision total hip arthroplasty (THA) between January 2000 and May 2013 treated with I&D. Implant retention was the outcome of interest. Sixty patients (29 men and 31 women; mean age 64.9 years) were identified. Mean follow-up was 59 months (range, 12-168). Results The implants were retained in 42 patients (70%). Failure of I&D treatment correlated with duration of symptoms > five days (p < 0.001) and obesity [body mass index (BMI) a parts per thousand yenaEuro parts per thousand 30)] (p = 0.0289). Treatment outcome was affected by the type of pathogen (p = 0.0482), with patients with methicillin-resistant staphylococci having significantly lower odds of success. Conclusions I&D can be a feasible option in THA patients presenting with acute deep PJI. Duration of symptoms > five days, isolation of methicillin-resistant staphylococci and obesity should be taken into consideration in pre-operative decision making.