Infection management after hip arthroplasty, what is commonly done?

• A. Antibiotics alone without surgery
• B. Observation only
• C. Debridement or two-stage revision
• D. Immediate hip dislocation treatment

Answer: (C)

When a hip arthroplasty becomes infected, the aim is to eradicate the infection while preserving function. If the infection is early (shortly after surgery) or an acute hematogenous event and the implant is stable with healthy soft tissue, a thorough surgical debridement with irrigation and exchange of modular components — often called DAIR — can control the infection without removing the prosthesis. For infections that are established or chronic, the most reliable approach is to remove the prosthesis, perform a thorough debridement, place an antibiotic spacer, and then reimplant a new prosthesis in a second operation after the infection is cleared. Antibiotics alone rarely solve a prosthetic joint infection because bacteria form protective biofilms on the implant surface. Observation is not appropriate for an active infection, and treating a dislocation does not address the infection.