Aims.
Aims. Accurate diagnosis of chronic periprosthetic joint infection (PJI) presents a significant challenge for hip surgeons. Preoperative diagnosis is not always easy to establish, making the intraoperative decision-making process crucial in deciding between one- and
Introduction. It is still controversial whether one or two-stage revision should be indicated for deeply infected hip prosthesis, and there are no scoring systems for the decision of them. An assessment system for the treatment of deeply infected hip prosthesis was evaluated for the patients who had undergone one or
Infected hip prosthesis, a devastating complication of primary total hip arthroplasty (THA) can lead to a serious condition. We report here the treatment outcome of our method of two-stage revision THA for infected hip arthroplasty using a temporary antibiotic-impregnated cement spacer for the period between resection and reimplantation. Between 1996 and 2000, we performed two-stage revision THA using a temporary antibiotic-impregnated cement spacer on eight hips in eight patients with infected hip arthroplasty including hemiarthroplasty, with the infection presenting itself between four days and 19.4 years after last operation. There were four females and four males, with a mean age of 67 years (58 to 72). The mean period of follow-up was 2.5 years (0.3 to 4.3). Cementless THA was implanted as the second srage procedure. Bone defects were restored with frozen allografts. The clinical outcome was evaluated using the hip score of the Japanese Orthopaedic Association (JOA hip score). The duration of follow-up was 33.9 months (range, 8 to 55 months). The mean JOA hip score at follow-up improved from 32.6 (19 to 74) to 77.1 (59 to 96). The mean interval period was 10.3 weeks (range, 6 to 19 weeks). Seven patients with infected hip arthroplasty successfully received implantation by two-stage cement-less revision THA. One patient with MRSA infection had a recurrence after four months of revision of THA. However, the two-stage procedure using a vancomicin-impregnated bone cement spacer and beads implantation successfully treated this patient 14 months after the first revision of THA. No recurrence of infection was found at 42 months of follow-up. These results suggest that two-stage revision THA using a temporary antibiotic-impregnated cement spacer is a useful technique for infected hip arthroplasty.
From a consecutive series of 114 patients who had undergone a two-stage exchange without prolonged antibiotic therapy we report the outcome of those patients who continued to have persistent infection.
Seven patients elected not to undergo a further two-stage revision. Five patients have retained their arthroplasty with lifelong suppressive antibiotic therapy. One has a pseudarthrosis and one disarticulation has taken place for inadequate tissue cover.
Purpose. Two-stage revision with the removal of all prosthesis has been considered to be the gold standard for treatment of periprosthetic joint infection. However, removal of well-fixed femoral stem is technically challenging and may cause excessive bone loss. The aim of this study was to compare the results between retention and removal of femoral stem when performing
The aim of revision hip arthroplasty for infection is to eradicate infection and restore function. There is, in current literature, little evidence to suggest an optimal time interval between first (excision) and second (reconstruction) stage procedures in revision hip arthroplasty. Our aim was to assess the difference in outcome, in terms of patient pain, function and satisfaction, in relation to the time interval between surgeries. A prospective analysis was made of 22 consecutive patients who underwent
We aimed to report the mid- to long-term rates of septic and aseptic failure after two-stage revision surgery for periprosthetic joint infection (PJI) following total hip arthroplasty (THA). We retrospectively reviewed 96 cases which met the Musculoskeletal Infection Society criteria for PJI. The mean follow-up was 90 months (SD 32). Septic failure was assessed using a Delphi-based consensus definition. Any further surgery undertaken for aseptic mechanical causes was considered as aseptic failure. The cumulative incidence with competing risk analysis was used to predict the risk of septic failure. A regression model was used to evaluate factors associated with septic failure. The cumulative incidence of aseptic failure was also analyzed.Aims
Methods