Preoperative Identification and Management of Skin Disorders Before Total Hip Arthroplasty: Two Case Reports and a Review of the Literature

Periprosthetic joint infection (PJI) is among the most devastating complications associated with total hip and knee arthroplasty (THA and TKA).Several risk factors for PJI have been identified; however, the bacterial skin flora at the surgery site has been underestimated.We present two cases of early identification of skin infection from Staphylococcus lugdunensis, Staphylococcus simulans and Staphylococcus epidermidis before THA, postponement of the surgery and targeted treatment of skin infection before rescheduling of THA.Four and three years after THA, patients remain without complications.The successful preoperative identification of skin inflammatory lesions around the hip led the surgeon to postpone the THA and treat them following consultation with an infectious disease specialist and a dermatologist.Careful preoperative skin preparation and observation by the surgeon are necessary.A review of the existing literature on these species as pathogens of PJI and the development of PJI in patients with skin disorders was conducted.