Treatment Challenges of Prosthetic Hip Infection with Associated Iliacus Muscle Abscess: Report of 5 Cases and Literature Review
<p class="p p-first" id="__p2">Prosthetic joint infection is an unfortunate though well-recognized complication of total joint arthroplasty. An iliacus and/or iliopsoas muscle abscess is a rarely documented presentation of hip prosthetic joint infection. It is thought an un...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Copernicus Publications
2017-03-01
|
| Series: | Journal of Bone and Joint Infection |
| Online Access: | https://jbji.copernicus.org/articles/2/127/2017/jbji-2-127-2017.pdf |
| _version_ | 1818676593215668224 |
|---|---|
| author | J. M. Lawrenz N. W. Mesko C. A. Higuera R. M. Molloy C. Simpfendorfer M. Babic |
| author_facet | J. M. Lawrenz N. W. Mesko C. A. Higuera R. M. Molloy C. Simpfendorfer M. Babic |
| author_sort | J. M. Lawrenz |
| collection | DOAJ |
| description | <p class="p p-first" id="__p2">Prosthetic joint infection is an unfortunate though well-recognized complication of total joint arthroplasty. An iliacus and/or iliopsoas muscle abscess is a rarely documented presentation of hip prosthetic joint infection. It is thought an unrecognized retroperitoneal nidus of infection can be a source of continual seeding of the prosthetic hip joint, prolonging attempts to eradicate infection despite aggressive debridement and explant attempts. The current study presents five cases demonstrating this clinical scenario, and discusses various treatment challenges.</p><p id="__p3">In each case we report the patient's clinical history, pertinent imaging, management and outcome. Diagnosis of the iliacus muscle abscess was made using computed tomography imaging. In brief, the mean number of total drainage procedures (open and percutaneous) per patient was 4.2, and outcomes consisted of one patient with a hip girdlestone, two patients with delayed revisions, and two patients with retained prosthesis. All patients ended with functional pain and on oral antibiotic suppression with an average follow up of 18 months.</p><p class="p p-last" id="__p4">This article highlights an iliacus muscle abscess as an unrecognized source of infection to a prosthetic hip. It demonstrates resilience to standard treatment protocols for prosthetic hip infection, and is associated with poor patient outcomes. Aggressive surgical debridement appears to remain critical to treatment success, and early retroperitoneal debridement of the abscess should be considered.</p> |
| first_indexed | 2024-12-17T08:45:56Z |
| format | Article |
| id | doaj.art-38a698c759184bba8b691766f1975b78 |
| institution | Directory Open Access Journal |
| issn | 2206-3552 |
| language | English |
| last_indexed | 2024-12-17T08:45:56Z |
| publishDate | 2017-03-01 |
| publisher | Copernicus Publications |
| record_format | Article |
| series | Journal of Bone and Joint Infection |
| spelling | doaj.art-38a698c759184bba8b691766f1975b782022-12-21T21:56:12ZengCopernicus PublicationsJournal of Bone and Joint Infection2206-35522017-03-01212713510.7150/jbji.16429Treatment Challenges of Prosthetic Hip Infection with Associated Iliacus Muscle Abscess: Report of 5 Cases and Literature ReviewJ. M. Lawrenz0N. W. Mesko1C. A. Higuera2R. M. Molloy3C. Simpfendorfer4M. Babic5Cleveland Clinic Foundation, 9500 Euclid Ave.Cleveland, OH 44195, USACleveland Clinic Foundation, 9500 Euclid Ave.Cleveland, OH 44195, USACleveland Clinic Foundation, 9500 Euclid Ave.Cleveland, OH 44195, USACleveland Clinic Foundation, 9500 Euclid Ave.Cleveland, OH 44195, USACleveland Clinic Foundation, 9500 Euclid Ave.Cleveland, OH 44195, USACleveland Clinic Foundation, 9500 Euclid Ave.Cleveland, OH 44195, USA<p class="p p-first" id="__p2">Prosthetic joint infection is an unfortunate though well-recognized complication of total joint arthroplasty. An iliacus and/or iliopsoas muscle abscess is a rarely documented presentation of hip prosthetic joint infection. It is thought an unrecognized retroperitoneal nidus of infection can be a source of continual seeding of the prosthetic hip joint, prolonging attempts to eradicate infection despite aggressive debridement and explant attempts. The current study presents five cases demonstrating this clinical scenario, and discusses various treatment challenges.</p><p id="__p3">In each case we report the patient's clinical history, pertinent imaging, management and outcome. Diagnosis of the iliacus muscle abscess was made using computed tomography imaging. In brief, the mean number of total drainage procedures (open and percutaneous) per patient was 4.2, and outcomes consisted of one patient with a hip girdlestone, two patients with delayed revisions, and two patients with retained prosthesis. All patients ended with functional pain and on oral antibiotic suppression with an average follow up of 18 months.</p><p class="p p-last" id="__p4">This article highlights an iliacus muscle abscess as an unrecognized source of infection to a prosthetic hip. It demonstrates resilience to standard treatment protocols for prosthetic hip infection, and is associated with poor patient outcomes. Aggressive surgical debridement appears to remain critical to treatment success, and early retroperitoneal debridement of the abscess should be considered.</p>https://jbji.copernicus.org/articles/2/127/2017/jbji-2-127-2017.pdf |
| spellingShingle | J. M. Lawrenz N. W. Mesko C. A. Higuera R. M. Molloy C. Simpfendorfer M. Babic Treatment Challenges of Prosthetic Hip Infection with Associated Iliacus Muscle Abscess: Report of 5 Cases and Literature Review Journal of Bone and Joint Infection |
| title | Treatment Challenges of Prosthetic Hip Infection with Associated Iliacus Muscle Abscess: Report of 5 Cases and Literature Review |
| title_full | Treatment Challenges of Prosthetic Hip Infection with Associated Iliacus Muscle Abscess: Report of 5 Cases and Literature Review |
| title_fullStr | Treatment Challenges of Prosthetic Hip Infection with Associated Iliacus Muscle Abscess: Report of 5 Cases and Literature Review |
| title_full_unstemmed | Treatment Challenges of Prosthetic Hip Infection with Associated Iliacus Muscle Abscess: Report of 5 Cases and Literature Review |
| title_short | Treatment Challenges of Prosthetic Hip Infection with Associated Iliacus Muscle Abscess: Report of 5 Cases and Literature Review |
| title_sort | treatment challenges of prosthetic hip infection with associated iliacus muscle abscess report of 5 cases and literature review |
| url | https://jbji.copernicus.org/articles/2/127/2017/jbji-2-127-2017.pdf |
| work_keys_str_mv | AT jmlawrenz treatmentchallengesofprosthetichipinfectionwithassociatediliacusmuscleabscessreportof5casesandliteraturereview AT nwmesko treatmentchallengesofprosthetichipinfectionwithassociatediliacusmuscleabscessreportof5casesandliteraturereview AT cahiguera treatmentchallengesofprosthetichipinfectionwithassociatediliacusmuscleabscessreportof5casesandliteraturereview AT rmmolloy treatmentchallengesofprosthetichipinfectionwithassociatediliacusmuscleabscessreportof5casesandliteraturereview AT csimpfendorfer treatmentchallengesofprosthetichipinfectionwithassociatediliacusmuscleabscessreportof5casesandliteraturereview AT mbabic treatmentchallengesofprosthetichipinfectionwithassociatediliacusmuscleabscessreportof5casesandliteraturereview |