Extensively Coated Non-modular Stem Used in Two-stage Revision for Infected Total Hip Arthroplasty: Mid-term to Long-term Follow-up

Objective: To determine the rate of curing the infection and mid-to long-term outcomes of using extensively coated non-modular stems in two-stage revision for infected total hip arthroplasty (THA). Methods: The clinical data of 33 patients (33 hips) in whom extensively coated non-modular stems had been used in two-stage revision THA for deep infection were retrospectively analyzed. All operations received two-stage reimplantation, which included resection arthroplasty, thorough debridement, insertion of a hand-molded antibiotic-impregnated cement spacer with stainless steel reinforcement, a course of intravenous antibiotics, and delayed reimplantation. Microorganism-specific antibiotics had been chosen according to the results of microbiological studies performed postoperatively. All patients received i.v. antimicrobial therapy for 4 weeks and oral antibiotics to which their organisms were sensitive for a further 6 weeks. Harris hip score (HHS) and plain X-ray films were used to perform clinical and radiological evaluations. Results: During follow-up for a minimum of 5 years, no reinfection or loosening were found. Cultures of samples taken during the second stage were all negative for infection. The mean HHS improved from 42 preoperative to 89 at the final follow-up. All granular bones had fused well with the host bones by 12 months after the surgery. Conclusion: Using extensively coated non-modular stems combined with intramedullary allografts in two-stage revision for treating infected THAs can achieve satisfactory outcomes.