Akos Zahar1, Ianiv Klaber2, Anne-Marie Gerken1, Thorsten Gehrke1, Matthias Gebauer3, Christian Lausmann1, Mustafa Citak1. 1. Department of Orthopaedic Surgery, Helios ENDO-Klinik Hamburg, Hamburg, Germany. 2. Department of Orthopedic Surgery, Pontificia Universidad Catolica de Chile, Santiago, Chile. 3. Department of Orthopaedic Surgery, Helios ENDO-Klinik Hamburg, Hamburg, Germany; Department of Orthopaedic Surgery, Roland-Klinik Bremen, Bremen, Germany.
Abstract
BACKGROUND: Although 2-stage revision is still considered the gold standard for surgical management of periprosthetic joint infection (PJI), 1-stage revision has been reported to be as effective. Long-term reports for 1-stage revision in hip PJIs are lacking. METHODS: We reviewed our 10-11 years of results of 85 patients who underwent 1-stage exchange of the hip with an antibiotic-loaded bone cemented prosthesis due to PJI to determine the following: (1) What is the infection-free survival? (2) What is the overall survival? and (3) What are the long-term clinical outcomes? All 1-stage revision total hip arthroplasties (THAs) for infection between January 2006 and December 2007, with a minimum 10-year follow-up (range 10-11), were included in this retrospective cohort. Patients from another country or patients who were unable to participate were excluded. Eighty-five patients with a hip PJI were available at the last follow-up. Thirty-seven patients died during the 10-year study. Harris Hip Scores were recorded before the surgery and at last follow-up. Failures are reported as infection-related or aseptic. RESULTS: The 10-year infection-free survival was 94% and the surgery-free survival was 75.9%. The Harris Hip Scores improved from 43 (range 3-91) to 75 (range 10-91) (P < .001). The main indication for re-revision after 1-stage exchange was instability (10/20 patients). CONCLUSION: One-stage exchange of the hip for PJI is a reliable treatment option with high rate of infection control and long-lasting favorable outcomes.
BACKGROUND: Although 2-stage revision is still considered the gold standard for surgical management of periprosthetic joint infection (PJI), 1-stage revision has been reported to be as effective. Long-term reports for 1-stage revision in hip PJIs are lacking. METHODS: We reviewed our 10-11 years of results of 85 patients who underwent 1-stage exchange of the hip with an antibiotic-loaded bone cemented prosthesis due to PJI to determine the following: (1) What is the infection-free survival? (2) What is the overall survival? and (3) What are the long-term clinical outcomes? All 1-stage revision total hip arthroplasties (THAs) for infection between January 2006 and December 2007, with a minimum 10-year follow-up (range 10-11), were included in this retrospective cohort. Patients from another country or patients who were unable to participate were excluded. Eighty-five patients with a hip PJI were available at the last follow-up. Thirty-seven patients died during the 10-year study. Harris Hip Scores were recorded before the surgery and at last follow-up. Failures are reported as infection-related or aseptic. RESULTS: The 10-year infection-free survival was 94% and the surgery-free survival was 75.9%. The Harris Hip Scores improved from 43 (range 3-91) to 75 (range 10-91) (P < .001). The main indication for re-revision after 1-stage exchange was instability (10/20 patients). CONCLUSION: One-stage exchange of the hip for PJI is a reliable treatment option with high rate of infection control and long-lasting favorable outcomes.
Authors: Mustafa Akkaya; Georges Vles; Iman Godarzi Bakhtiari; Amir Sandiford; Jochen Salber; Thorsten Gehrke; Mustafa Citak Journal: Int Orthop Date: 2022-01-04 Impact factor: 3.075
Authors: Thomas K Fehring; Keith A Fehring; Angela Hewlett; Carlos A Higuera; Jesse E Otero; Aaron J Tande Journal: J Bone Joint Surg Am Date: 2020-07-15 Impact factor: 6.558