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Archives of Orthopaedic and Trauma Surgery

Published in:

01-10-2018 | Orthopaedic Surgery

Total hip arthroplasty following illicit drug abuse

Authors: Tim Ramczykowski, Christiane Kruppa, Thomas Armin Schildhauer, Marcel Dudda

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 10/2018

Abstract

Background

The role of illicit drug abuse in total joint arthroplasty is largely unknown and is likely underestimated. Patients with drug addictions often suffer from septic osteoarthritis or a necrosis of the femoral head. Purpose of the study was to evaluate the operative management and clinical outcome of total hip replacement in patients with a history of intravenous drug abuse.

Methods

This retrospective study included 15 patients with a history of intravenous drug abuse who underwent total hip arthroplasty. A total of 6 females and 9 males with an average age of 34.3 years were identified. Ten patients presented an acute bacterial coxitis (Coxitis-group) and five an aseptic osteonecrosis of the femoral head (Osteonecrosis-group).

Results

Ten patients with a bacterial coxitis underwent a two-staged total hip arthroplasty (THA), with temporary insertion of a drug-eluting spacer. Five patients with a necrosis of the femoral head were primarily treated with THA. All patients developed multiple re-infections after insertion of a drug-eluting spacer or THA. Only two patients finally achieved a THA without infection in the period of 3.9 years follow-up. The other 13 patients underwent a Girdlestone arthroplasty (7 patients) or total joint replacement with a chronic fistula (6 patients).

Conclusion

THA in patients with illicit drug abuse shows a low success rate. Following septic osteoarthritis or osteonecrosis in drug-addicted patients, we recommend a two-stage procedure with temporary insertion of a drug-eluting spacer. THA might follow only under strict premises.

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Title: Total hip arthroplasty following illicit drug abuse
Authors: Tim Ramczykowski
Christiane Kruppa
Thomas Armin Schildhauer
Marcel Dudda
Publication date: 01-10-2018
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 10/2018
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-018-2980-3

ACC 2024 Congress

Springer Medicine

Total hip arthroplasty following illicit drug abuse

Abstract

Background

Methods

Results

Conclusion

ACC 2024 Congress

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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