Infection after a total hip replacement is uncommon but represents one of the most serious complications in joint replacement surgery. Over the years, the diagnosis and management of infected hip replacements have become more standardized and effective, allowing patients to regain mobility with confidence when addressed early. Hip replacement infections, like knee infections, are classified into acute (less than 3 months), subacute (3–24 months), and chronic (more than 24 months) based on the time of onset after surgery.
These symptoms can appear weeks or even months after surgery. If such signs occur, especially drainage or fever, medical help should be sought immediately. Based on symptoms, clinical examination, and patient history, the likelihood of infection can be assessed early and accurately.
After clinical and temporal characterization, laboratory tests form part of the investigation of infections. C-reactive protein (CRP) levels and erythrocyte sedimentation rate (ESR) are evaluated in patients with suspected TKA infection.
Imaging examinations like x-rays, ultrasound scans can also be used, where appropriate, or bone or white cell scans, which are performed when relevant.
Treatments can vary depending on the complexity and timing of initial surgery - whether the infection early after surgery (less than 3 months), 12-24 months or 2 years after.
Most early infections can be addressed with thorough washout with a liner change and multiple debridement and washouts, in addition to 6 weeks to 3 months course of antibiotics. This is called DAIR – debridement, antibiotics and implant retention. Patients who have a long history of symptoms or have sinus tracts are less likely to benefit from this treatment method.
It’s important to reduce the risk factors of joint infections such as obesity, smoking, control diabetes, control heart diseases or chronic health problems and optimise these before surgery with a peri operative-physician.
It is also imperative for patients to ask their surgeon what precautions they should take before, during and after surgery that can reduce the risk of infection.
Orthonova Hospital, Jalandhar takes immense pride in being among the select few hospitals globally with zero percent infection rate in primary joint replacements over the last decade. This exceptional achievement reflects our rigorous infection prevention protocols, world-class surgical expertise, and unwavering commitment to safe, high-quality patient care—despite handling a large volume of surgeries and patients from across India and overseas.
