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General Orthopaedics

POSITIVE MSIS MINOR-CRITERIA HAVE AN IMPACT ON THE OUTCOME OF THA AND TKA REVISIONS: A MATCHED-PAIR ANALYSIS

European Bone and Joint Infection Society (EBJIS) meeting (1–3 September 2016).



Abstract

Aim

Aim of the study was to find out whether patients with positive minor criteria but without meeting the MSIS definition have a difference in the outcome after revision-surgery compared to patients without any MSIS-criteria? And does the reason for revision-surgery (eg. loosening) have an additional influence on the outcome parameters in patients with positive minor criteria?

Method

A retrospective matched-pair analysis with 98 patients who had undergone revision-surgery after TJA was performed. Forty-nine patients who showed 1 to 3 positive minor criteria (PMC) whereas 49 patients without any positive minor criteria (aseptic complications control group) were compared regarding re-revision-rate and revision-free survival. Patients were matched regarding sex, age, joint and comorbidities using the classification system by McPherson et al. Reasons for revisions were categorized in loosening, body wear, periprosthetic fracture/mechanical failure and soft-tissue complication. Endpoints were defined as re-revision for any cases.

Results

In the group of patients with PMC 30.6% (n=15) had to undergo re-revision compared to 6.12% (n=3) in the true aseptic complication (AC) control group. The overall-survival in the PMC-group was 69.4% (95% CI: 47–69 months) and in the AC-group 93.9% (95% CI: 82–94 months) (p=0.001). In patients with PMC but not exchange of the implant the overall-survival was 94.1% (95%CI survival time: 71–88 months) and in comparison the cohort with exchange of the prosthesis showed an overall-survival of 56.25% (95% CI survival time: 29–53 months) (p=0.008).

Conclusions

Our findings suggest that in dependence of the occurrence of prosthetic loosening even single positive minor-criteria may have an impact on the outcome after THA- and TKA revision-surgeries.


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