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How are hip replacement infections treated?

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Antibiotics can often cure shallow infections of the soft tissue around the surgical site from a hip replacement, but deeper infections around the hip replacement itself require surgery, American Academy of Orthopaedic Surgeons says. If caught within several days of onset, debridement, a procedure that removes contaminated soft tissues and cleans the interior space around the joint, may be sufficient. Infections that occur a long time after surgery or that do not receive treatment quickly enough require joint removal.

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Both types of surgical treatment require a course of antibiotics afterward, states American Academy of Orthopaedic Surgeons. When a surgeon removes a replacement hip joint because of infection, he cleans out the interior space as with debridement. He then temporarily replaces the artificial joint with a device known as an antibiotic spacer. This device is made of surgical cement and maintains joint spacing and position. It also contains antibiotics that seep out into the space around the joint to help kill any remaining bacteria. The patient also receives intravenous antibiotics. After at least six weeks with the antibiotic spacer, the surgeon installs another hip replacement.

Hip replacements are vulnerable to infection not only after surgery but any time there is an infection in the body, American Academy of Orthopaedic Surgeons explains. Because they are made of metal and plastic, the immune system has trouble fighting bacteria that reach them, so the artificial joints can become a protected source for infections.

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