Modern state of problem for treating patients with reccurent hip periprosthetic joint infection (literature review)

Hip PJI is a frequent and severe complication of widespread hip arthroplasty surgeries that has high risks for disability and early mortality among particular patients. Patients with chronic recurrent hip PJI are the most complicated to treat. Their treatment efficiency is 60-70% on the average. The aim of the study is to review the most significant aspects of treating patients with chronic recurrent hip PJI and modern options for the relapse risk decrease by approving the rational choice of sanating operations and optimizing the perioperative course. The definition of PJI recurrence is revealed in the result of the performed analysis. Development risk factors of this disease and currently used surgical interventions are elucidated. The authors paid a special attention to the unresolved issues of the treatment: closed suction drainage, modification of systemic anticoagulants schemes, influence of soft and bone defects volumes, pathogen type and patients comorbidities. The performed analysis of scientific investigations revealed that there is no scientifically approved and clinically certified decision making treatment algorithm including the type of surgery for recurrent hip PJI cases. Wherein the efficiency of using approaches remains low and does not satisfy neither doctors nor patients. This situation is related with the amount of inappropriately investigated issues of perioperative management and besides of influences of different factors upon the failure coincidence of recurrent PJI treatment result