LES INFECTIONS SUR PROTHESES DE HANCHE : QUELLE STRATEGIE THERAPEUTIQUE ?

As prosthetic hip infection is one of the most feared complications of hip arthroplasty, the aim of our work was, on the one hand, to describe different possible therapeutic options for treating and managing PHI, and on the other hand, to establish a strategy according to the type of infection and the characteristics of each patient. This is a retrospective study concerning 12 cases of prosthetic hip infection, conducted at the Department of Orthopedic Surgery and Trauma (A) of the Ibn Tofail Hospital in Marrakech and the Grand Atlas Clinic, during a period ranging from January 2017 to December 2020. The average age of our patients was 63 years, with a predominance of women (66% of cases). The distinction of PHI from other causes of painful hip arthroplasties is not obvious, therefore its diagnosis is based on a cluster of arguments clinical, radiological and biological pre and intraoperative. We were able to divide our patients according to the type of infection, 41.6% had an early postoperative infection and 58.4% had a delayed chronic infection. This classification as well as the particularities of each patient allowed us to choose the optimal therapeutic strategy and to adapt it according to the evolution of the infection. Indeed, targeted antibiotic therapy, in association with surgery, is essential. Thus, preservation of the prosthetic implant is indicated in early infections (< 4 weeks), while its change is reserved for delayed chronic infections. At the end of this study, we were able to establish a medico-surgical therapeutic strategy adapted to our service and the practical recommendations for the management of infections on prostheses.