Association between psoas abscess and prosthetic hip infection: a case-control study

Acta Orthop. 2009 Apr;80(2):198-200. doi: 10.3109/17453670902947424.

Abstract

Background and purpose: The relationship between prosthetic hip infection and a psoas abscess is poorly documented. We determined the frequency of prosthetic hip infections associated with psoas abscesses and identified their determinants.

Methods: We conducted a 2-year observational study. Data from patients with psoas abscesses that were associated with prosthetic hip infections were examined in a case-control study.

Results: Of 106 patients admitted to the Infectious Diseases Department with prosthetic hip infection, 13 also had a psoas abscess (12%; 95% CI: 6-19). By conditional logistic regression analysis, psoas abscesses were observed more frequently in cases of hematogenous prosthetic infections (OR = 93, p = 0.06) and in patients with a history of neoplasm (OR = 20, p = 0.03).

Interpretation: Our results suggest that the presence of psoas abscesses is a frequent but under-diagnosed complication of prosthetic hip infection. We recommend that an abdominal CT scan be performed on patients with hematogenous prosthetic hip infection or with a history of neoplasm.

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Case-Control Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prosthesis Failure
  • Prosthesis-Related Infections / etiology*
  • Prosthesis-Related Infections / microbiology
  • Psoas Abscess / complications*
  • Psoas Abscess / diagnostic imaging
  • Psoas Abscess / microbiology
  • Reoperation
  • Retrospective Studies
  • Risk Factors
  • Tomography, X-Ray Computed