Adult septic hip washout is an emergency operation to drain an infected native or prosthetic hip joint. Prompt surgical drainage combined with antibiotics is essential to prevent cartilage destruction and systemic sepsis.
For native hips: an incision over the anterior or lateral hip. The joint capsule is opened, pus drained, and the joint thoroughly irrigated with litres of saline. Multiple tissue samples are taken for microbiology. A drain may be left. For prosthetic hips: DAIR is performed — the joint is debrided, washed, and modular components exchanged. The operation takes 45–90 minutes.
Septic arthritis of the hip is less common in adults than children but is a serious condition requiring urgent surgery. Risk factors include rheumatoid arthritis, immunosuppression, diabetes, intravenous drug use, and prosthetic joints.
Needle aspiration under imaging guidance may be diagnostic and temporarily therapeutic, but established septic arthritis requires formal surgical washout.
Emergency procedure. Blood cultures, inflammatory markers. Joint aspiration for urgent Gram stain and culture. MRI or ultrasound confirming effusion.
Drainage of infection, joint preservation, and prevention of cartilage destruction. Outcomes depend on timing — earlier treatment gives better results.
IV antibiotics for two to six weeks.
Post-infectious arthritis and adhesions.
May require repeat washout.
Irreversible if treatment is delayed.
Rare in adults but possible with intra-articular pressure.
May worsen before improving.
Accelerated arthritis requiring future hip replacement.
General or spinal anaesthesia. Emergency.
IV antibiotics two to six weeks. Physiotherapy for hip mobility once infection controlled. Protected weight-bearing initially. Full recovery depends on cartilage damage.
Regular blood tests. Clinical review at two, six weeks, three months. Long-term monitoring for secondary arthritis.
If the cartilage is damaged by the infection, post-infective arthritis may develop, eventually requiring hip replacement. The risk depends on how quickly the infection was treated.