Abstract
Resection arthroplasty can be performed as the first stage of a two-stage procedure in some patients with severe periprosthetic hip joint infections with poor bone stock. This retrospective study aimed to evaluate factors associated with the subsequent failure or success of these patients. Between 2011 and 2020; in 61 (26.4%) of 231 patients who underwent a two-stage protocol of periprosthetic hip joint infections; no spacer was used in the first stage. The minimum follow-up period was 12 months. Patient’s demographics and various infection risk factors were analyzed. In total, 37/61 (60.7%) patients underwent a successful reimplantation, and four patients died within the follow-up period. Patients within the failure group had a significantly higher Charlson comorbidity index (p = 0.002); number of operations prior to resection arthroplasty (p = 0.022) and were older (p = 0.018). Failure was also associated with the presence of a positive culture in the first- and second-stage procedures (p = 0.012). Additional risk factors were persistent high postoperative CRP values and the requirement of a negative-pressure wound therapy (p ≤ 0.05). In conclusion, multiple factors need to be evaluated when trying to predict the outcome of patients undergoing resection arthroplasty as the first stage of a two-stage procedure in patients with challenging periprosthetic hip joint infections.
Highlights
Two-stage exchange arthroplasty with a temporary antibiotic-loaded cement spacer remains the most widely used strategy for the management of chronic periprosthetic hip joint infections [1,2]
Patient Demographics and Factors Associated with a Failed Two-Stage Protocol
Four patients died within the follow-up period at days 12, 73, 88 and 126 after resection arthroplasty
Summary
Two-stage exchange arthroplasty with a temporary antibiotic-loaded cement spacer remains the most widely used strategy for the management of chronic periprosthetic hip joint infections [1,2]. In severe cases with poor bone stock and/or abductor insufficiency, a non-spacer option can be performed [3]. This resection arthroplasty procedure generally leads to a poor functional status in the interim stage [4,5]. Patients’ risk factors associated with periprosthetic joint infections (PJIs) include surgical site infection score (SSI), Charlson comorbidity index (CCI), BMI, serum C-reactive protein (CRP) levels, older age and sex [6–13]. These factors are not always associated with persistent infections or failure of a septic revision surgery. Outcome studies in patient groups with PJIs are hard to compare due to their heterogeneous characteristics
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
