Background and Objectives: When prosthetic joint infections, known for their high morbidity, are caused by high-virulence organisms such as Staphylococcus, the outcomes are even worse. This study aims to examine the outcomes of staphylococcal prosthetic joint infections after hemiarthroplasty for hip trauma patients, which has not been particularly reported. Materials and Methods: A retrospective study was performed in a level 1 trauma center to review all the cases of prosthetic joint infections in our database. Patients’ demographics, clinical inpatient, surgical, and outpatient notes, laboratory results, and serial radiographs were assessed to extract all relevant data. Results: Out of 2477 hip hemiarthroplasty cases reviewed, a total of 36 prosthetic joint infection cases caused by Staphylococcus species in 36 patients were included in this study. Patients were 26 females and 10 males with a mean age of 76.5 years at the time of surgery. Fifteen cases had infections with methicillin-resistant Staphylococcus aureus (MRSA) while twenty-one cases had infections with other Staphylococcus species. The mean follow-up for all cases is 43.5 months. Twenty-nine cases underwent at least a single trial for surgical debridement and implant retention surgery, and only nine (31%) had successful debridement and implant retention. The 3-month, 1-year, and 3-year cumulative mortality for all cases was 22.2, 30.5, and 41.7%, respectively. Conclusions: Staphylococcal hemiarthroplasty infection is a devastating complication that is associated with a low success (31%) of implant retention surgery, significantly high morbidity, and high cumulative mortality.

Background: The effectiveness of hip hemiarthroplasty in managing femoral neck fractures in individuals with cerebral palsy has seldom been reported. Objectives: Given the complex neuromuscular issues associated with cerebral palsy (CP), this retrospective study aims to document the outcomes and characterize the complications of hip hemiarthroplasty for fractures of the femoral neck in a series of patients with CP, emphasizing the role of precision medicine in management. Methods: Six cases of hip hemiarthroplasty in six male patients with cerebral palsy and displaced femoral neck fractures have been reviewed in this study. The patients’ mean age at the time of surgery was 55.6 ± 14.1 years (range, 33–71). All the patients were independent indoor ambulators before their femoral neck fracture and had various medical comorbidities. Five patients had intellectual disabilities. Results: The mean clinical and radiographic follow-ups for the patients included in this series were 91.5 and 71.3 months, respectively. All the patients developed significant heterotopic ossification (HO) around the operated hip, which was observed as early as the second week postoperatively on radiographs. HO progressed throughout the follow-up for all the patients. One patient had an early postoperative dislocation with femoral stem loosening, which was managed by implant revision. Another patient had an acetabular protrusion, leading to the loss of their weight-bearing ability and mobility due to pain. Four patients were deceased at a mean of 86.5 months after the index surgery. Conclusions: After considering the preliminary evidence provided with this small case series, this study suggests the overall guarded outcomes of hip hemiarthroplasty in patients with CP. Given the 100% rate of heterotopic ossification, a precision medicine framework with consideration for HO prophylaxis may be recommended after hip hemiarthroplasty in patients with CP. It may also be reasonable to scrutinize a personalized risk assessment approach in this patient subset regarding decision making, surgical approach, and rehabilitation program. The clinical outcomes and the risks of complications following hemiarthroplasty should be sensibly presented to patients with cerebral palsy and their caregivers to achieve reasonable postoperative expectations.