Ph Hernigou, A Poignard, CH Flouzat Lachaniette (Créteil)
Although the presence of osteonecrotic bone is known to make joints more prone to infection, to our knowledge no many cases of THA after septic hip joint has been reported. The clinical features at the time of admission, imaging findings suggesting the diagnosis, modes of treatment and sequelae of septic arthritis of forty-four hip joints with osteonecrosis in patients with sickle cell disease(30 patients) and without sickle cell disease ( 10 patients) were studied retrospectively over a 25-years period. This study evaluated also the complications, the efficiency and the risk of total hip arthroplasty in these patients.
Most patients were in the third decade of life. Staphylococcus and Gram negative infection predominated in childhood or in adult life. Treatment was first conservative but most of the patients needed surgery to treat infection and sequelae related to infection. A total hip arthroplasty was performed later between 3 months and 20 years after the acute infection. No deaths were observed, but complications occurred.
With an experienced surgical and medical team and multidisciplinary management of these patients undergoing total hip arthroplasty after hip infection, our rate of complications was acceptable.