[Femorotomy and cleaning for infected hip prostheses: report of 30 cases]. / Fémorotomie de nettoyage dans les prothèses de hanche infectées: à propos de 30 cas.

PURPOSE: We report infected hip prostheses treated by an original technique: frontal femorotomy after trochanterotomy. MATERIAL AND METHODS: This extensive technique enables perfect cleaning of the femur and truly effective freshening of the endomedullar canal. We report 30 cases operated since 1991 use of femorotomy has been systematic from 1995. RESULTS: We were able to reimplant 25 of these 30 hips. Our results after infection were rather good with 4 recurrent infections in difficult cases (multi-operated patients and multiresistant germs in half of the cases). Fusion of femorotomy was obtained in all cases. The mechanical outcome was not improved by femorotomy. The main problem was trochanter nonunion with 5 cases, all of them having had a trochanteromy during the first procedure. DISCUSSION: We use femorotomy as our routine technique for femoral cleaning in case of hip prosthesis infection. In less complicated cases, we do not remove the trochanter from the femoral valve, limiting trochanteric complications, the main problem with this technique.