Treatment of an infected total hip replacement with the PROSTALAC system. Part 2: Health-related quality of life and function with the PROSTALAC implant in situ.

INTRODUCTION Infection after total hip replacement (THR) adversely affects patients' function and health-related quality of life (HRQL). A prosthesis with antibiotic-loaded acrylic cement (PROSTALAC) was designed to improve the function and quality of life of patients undergoing treatment for infected THR. METHODS We assessed 23 patients with the PROSTALAC implant in situ for treatment of an infected THR for function and HRQL, using standardized outcome measures. These patients were compared with a referent cohort of patients who had undergone assessment of function and HRQL before and 6 months after primary THR in the same tertiary health centres. RESULTS The mean (standard deviation) Western Ontario MacMaster (WOMAC) scores for PROSTALAC patients were 70.0 (21.1), 65.8 (20.4) and 63.0 (21.1) for pain, stiffness and function, respectively. The median Harris Hip score was 62.3 (minimum 20.4, maximum 86.3) and median global hip range of motion was 100.0 (minimum 80.0, maximum 140.0) degrees. CONCLUSION The mean WOMAC scores for pain, stiffness and function were better than they were for patients awaiting THR but not as good as 6 months after primary THR. The PROSTALAC implant allows patients to have reasonable function and quality of life during the interim treatment for deep joint infection.