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This case report describes the successful management of an acute prosthetic joint infection (PJI) following a two-stage revision total hip arthroplasty (THA) in a 37-year-old male with hepatitis C. The patient, who had a constrained acetabular cup implanted, developed a wound dehiscence and purulent discharge. The infection was managed with debridement, antibiotics, implant retention (DAIR), and musculocutaneous anterolateral thigh flap coverage, with no evidence of infection at 12-month follow-up.
DAIR with anterolateral thigh flap coverage can be a viable option for managing acute PJI after revision THA, especially when resources are limited.
Abstract Introduction: Infection following a primary total hip arthroplasty (THA) is a devastating complication. An infected revision THA carries even more significant consequences. This case report describes the successful management of an infected revision THA using debridement, antibiotics, implant retention (DAIR), and a musculocutaneous anterolateral thigh flap coverage in a resource-constrained setting. Case Report: A 37-year-old male patient with hepatitis C presented with a sinus tract at the surgical site following implant removal for an infected THA. He underwent a two-stage revision, utilizing a constrained acetabular cup, due to a lack of identifiable abductor mass observed intraoperatively. Postoperatively, the surgical site dehisced with purulent discharge with exposure of the greater trochanter and trunnion. In consultation with a plastic surgeon, DAIR with musculocutaneous anterolateral thigh flap coverage was done. At 12-month follow-up, the flap remained healthy and well settled, without evidence of infection. Conclusion: This case highlights the potential of DAIR with flap coverage as a valuable option for managing infected revision THA, particularly in resource-limited settings, considering the associated complications, morbidity, and cost of further revisions.
