Overview
Splinter infections in the hip, particularly following surgical interventions like Girdlestone arthroplasty, can lead to significant complications including persistent infection and prosthetic dislocations. 1Diagnosis
Clinical Presentation: Persistent pain, swelling, and signs of systemic infection (fever, elevated inflammatory markers).
Imaging: Radiography and MRI to assess for signs of infection and prosthetic loosening.
Laboratory Tests: Elevated white blood cell count, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP).
Culture and Sensitivity: Essential for identifying the causative organism and guiding antibiotic therapy. 1Management
Antibiotic Therapy: Broad-spectrum initially, tailored based on culture and sensitivity results. Specific drug classes not detailed in the abstract.
Surgical Intervention: Reimplantation of total hip arthroplasty after infection eradication; resection arthroplasty as a salvage procedure.
Postoperative Care: Close monitoring for complications such as dislocation, infection recurrence, and trochanteric nonunion.
Physical Therapy: Gradual mobilization to prevent complications like persistent limp. 1Special Populations
Elderly: Higher risk of complications including dislocations and persistent limp; careful postoperative management crucial. 1Key Recommendations
Reimplantation after Girdlestone arthroplasty can achieve high infection-free success rates (97.7%), but requires vigilant monitoring for complications like dislocation and nonunion. (Evidence: Moderate) 1
Early identification and aggressive management of infection are critical to prevent persistent infection and the need for rerevision surgery. (Evidence: Moderate) 1
Postoperative physical therapy should be tailored to minimize complications such as persistent limping, especially in elderly patients. (Evidence: Expert opinion) 1References
1 Charlton WP, Hozack WJ, Teloken MA, Rao R, Bissett GA. Complications associated with reimplantation after girdlestone arthroplasty. Clinical orthopaedics and related research 2003. link