A New Hip for the Adult Who had a Childhood Hip Infection

In rare cases, infections can invade a child’s hip joint. The result is a hip joint that does not grow and develop properly. These children commonly grow up to need a surgery called total hip replacement (THR).

But THR is not a simple surgery in patients who had childhood hip infections. After infection, the bones that form the hip may be weak and poorly shaped. The muscles and other tissues around the hip may also have become tight and weak. Doctors are concerned about the possibility of reinfection. And these patients need THR when they are still young and active, making problems after surgery more likely.

These doctors followed up on 170 THR surgeries done in patients who had childhood hip infections. The patients’ average age when they had the hip infection was seven. Their average age when they had THR was about 42. The authors looked at the THR results for 10 years after the surgeries. They write in detail about the different types of hip damage, implants, and results. Here are some highlights:

  • Only two hip joints (in the same patient) became infected after THR. This patient was the only one who had the original infection less than 10 years before THR surgery. This supports earlier research that suggested that THR should not be done until 10 years after a hip infection.
  • THR significantly improved function in these patients.
  • About 15 percent of the patients needed revision THR later to correct problems with the original implant. This is higher than the general population of THR patients.
  • The implants develop loosening at much higher rates than for normal THR surgeries.
  • Over half of the patients developed osteolysis (softening of the bone around the implant). It was associated with increased wear in the parts of the implant. The authors think this is because the implants were not as high quality as newer implants and because the patients were younger and more active than average THR patients.

    The authors note that it is especially important to wait for 10 years after the original infection before attempting surgery. They also stress that doctors must test the joint for any lingering infection before doing THR.