BACKGROUND: The treatment for an early postoperative periprosthetic infection after cementless THA that results in the highest quality of life after the control of infection is unknown. Although common treatments include irrigation and débridement with component retention, a one-stage exchange, or a two-stage exchange, it is unclear whether any of these provides a higher quality of life after the control of infection. QUESTIONS/PURPOSES: We projected, through decision-analysis modeling, the possible estimated final health states defined as health-related quality of life based on quality-of-life studies of an early postoperative periprosthetic infection after cementless THA treated by irrigation and débridement, one-stage exchange, or two-stage exchange. METHODS: Publications addressing early postoperative infections after THA were analyzed for the estimated rate of infection control and quality-of-life measures after a specific treatment. Decision analysis was used to model the different treatments and describe which, if any, treatment results in the greatest quality of life after early THA infection. RESULTS: In the model, a one-stage exchange was the treatment for early THA infection that maximized quality-of-life outcomes if the probability of controlling the infection exceeded 66% with this procedure. If the probability of infection control of a one-stage exchange was less than 66% or that of irrigation and débridement was greater than 60%, then irrigation and débridement appeared to result in the greatest quality-of-life outcome. CONCLUSIONS: A decision analysis using estimates of infection control rate and quality-of-life outcomes after different treatments for an early postoperative infection after THA showed possible outcomes for each treatment. LEVEL OF EVIDENCE: Level II, economic and decision analyses. See Guidelines for Authors for a complete description of levels of evidence.
BACKGROUND: The treatment for an early postoperative periprosthetic infection after cementless THA that results in the highest quality of life after the control of infection is unknown. Although common treatments include irrigation and débridement with component retention, a one-stage exchange, or a two-stage exchange, it is unclear whether any of these provides a higher quality of life after the control of infection. QUESTIONS/PURPOSES: We projected, through decision-analysis modeling, the possible estimated final health states defined as health-related quality of life based on quality-of-life studies of an early postoperative periprosthetic infection after cementless THA treated by irrigation and débridement, one-stage exchange, or two-stage exchange. METHODS: Publications addressing early postoperative infections after THA were analyzed for the estimated rate of infection control and quality-of-life measures after a specific treatment. Decision analysis was used to model the different treatments and describe which, if any, treatment results in the greatest quality of life after early THA infection. RESULTS: In the model, a one-stage exchange was the treatment for early THA infection that maximized quality-of-life outcomes if the probability of controlling the infection exceeded 66% with this procedure. If the probability of infection control of a one-stage exchange was less than 66% or that of irrigation and débridement was greater than 60%, then irrigation and débridement appeared to result in the greatest quality-of-life outcome. CONCLUSIONS: A decision analysis using estimates of infection control rate and quality-of-life outcomes after different treatments for an early postoperative infection after THA showed possible outcomes for each treatment. LEVEL OF EVIDENCE: Level II, economic and decision analyses. See Guidelines for Authors for a complete description of levels of evidence.
Authors: Charlotte B Phillips; Jane A Barrett; Elena Losina; Nizar N Mahomed; Elizabeth A Lingard; Edward Guadagnoli; John A Baron; William H Harris; Robert Poss; Jeffrey N Katz Journal: J Bone Joint Surg Am Date: 2003-01 Impact factor: 5.284
Authors: Nizar N Mahomed; Jane A Barrett; Jeffrey N Katz; Charlotte B Phillips; Elena Losina; Robert A Lew; Edward Guadagnoli; William H Harris; Robert Poss; John A Baron Journal: J Bone Joint Surg Am Date: 2003-01 Impact factor: 5.284
Authors: Justin S Cummins; Ivan M Tomek; Stephen R Kantor; Ove Furnes; Lars Birger Engesaeter; Samuel R G Finlayson Journal: J Bone Joint Surg Am Date: 2009-03-01 Impact factor: 5.284
Authors: Erik Hansen; Matthew Tetreault; Benjamin Zmistowski; Craig J Della Valle; Javad Parvizi; Fares S Haddad; William J Hozack Journal: Clin Orthop Relat Res Date: 2013-10 Impact factor: 4.176
Authors: Mariano Fernandez-Fairen; Ana Torres; Ann Menzie; Daniel Hernandez-Vaquero; José Manuel Fernandez-Carreira; Antonio Murcia-Mazon; Enrique Guerado; Luis Merzthal Journal: Open Orthop J Date: 2013-06-14
Authors: Joseph K Antonios; Kevin J Bozic; Henry D Clarke; Mark J Spangehl; Joshua S Bingham; Adam J Schwartz Journal: Arthroplast Today Date: 2021-10-05
Authors: Daniel Hernández-Vaquero; Mariano Fernández-Fairen; Ana Torres; Ann M Menzie; José Manuel Fernández-Carreira; Antonio Murcia-Mazon; Enrique Guerado; Luis Merzthal Journal: ScientificWorldJournal Date: 2013-05-28