How to manage an infected hip prosthesis?
Q: My mother is 68 years old. She weighs 65 kg and is 5 feet 1 inch tall. Her femur (hip) neck broke last year and she had a replacement of the neck (prosthesis). Unfortunately after 3 months she developed severe infection and the wound had to be reopened as suggested by our doctor. It was cleaned and she was kept under antibiotics. But when antibiotics were stopped, she had severe pain and when she underwent gallium scan, her prosthesis showed infection. She also has hiatus hernia and anaemia, but no other ailments like diabetes or high blood pressure. If we replace the prosthesis by antibiotics, we may have to replace it again after 2-3 years as told by the doctor. The other option is to remove the prosthesis. How much will she limp if we go without any prosthesis? Will she be able to live a pain free life with some limping or discomfort?
A:Your mother needs a total hip replacement after control of infection. This can be expedited by the implantation of antibiotic beads or collagen implant to deliver antibiotics locally in a very high concentration. This will do so more certainly than systemic antibiotics. Then when the infection is under control she can have a total hip replacement.