Abstract

BackgroundDebates persist on the optimal surgical approach for treating Periprosthetic joint infection (PJI) following total hip arthroplasty (THA). This meta-analysis aimed to compare the reinfection rate of one-stage revision versus two-stage revision for PJI after THA.MethodsA comprehensive search was performed in four databases (PubMed, Embase, Web of Science, and Cochrane Library) to locate articles that assessed the reinfection rate of one-stage revision compared to two-stage revision. Meta-analyses of reinfection rate were performed.ResultsA total of 14 articles including of 1429 patients were chosen for inclusion in this meta-analysis, with 561 patients in the one-stage group and 868 patients in the two-stage group. The meta-analysis of the 14 trials revealed that there was no statistically significant disparity in the reinfection rate between the two groups(OR = 1.34, 95% CI 0.92 ~ 1.93, P = 0.12, I2 = 0). A subgroup analysis was conducted based on the presence of a well-defined algorithm for decision making in either a one-stage or two-stage revision. There was no statistically significant difference in reinfection rate between one-stage and two-stage revision if there was a decision algorithm(OR = 0.83, 95% CI 0.44 ~ 1.54, P = 0.55, I2 = 0). If not, the reinfection rate of one-stage revision was significantly higher than that of two-stage revision(OR = 1.79, 95% CI 1.11 ~ 2.88, P = 0.02, I2 = 0). Postoperative hip function score was significantly better in the one-stage revision group than that of the two-stage revision group(SMD = 0.54, 95% CI 0.31 ~ 0.78, P<0.05, I2 = 79%).ConclusionsA strategy that is clearly defined and can be used for decision making in one-stage or two-stage revision is necessary for the treatment of PJI after THA. When there is significant damage to the soft tissue and/or the presence of strong microorganisms, a two-stage revision is recommended in order to decrease the reinfection rate. One-stage revision is recommended for patients with low-toxic infections and intact soft tissue.Trial registrationPROSPERO (CRD42023450842, 17 August 2023) https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023450842.

Full Text

Published Version

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 call

Disclaimer: 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.