Repeat two-stage exchange arthroplasty for prosthetic hip re-infection

T S Brown; K A Fehring; M Ollivier; T M Mabry; A D Hanssen; M P Abdel

doi:10.1302/0301-620X.100B9.BJJ-2018-0470.R1

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Repeat two-stage exchange arthroplasty for prosthetic hip re-infection

Journal article

Peer reviewed

Repeat two-stage exchange arthroplasty for prosthetic hip re-infection

T S Brown, K A Fehring, M Ollivier, T M Mabry, A D Hanssen and M P Abdel

The bone & joint journal, Vol.100-B(9), pp.1157-1161

09/2018

DOI: 10.1302/0301-620X.100B9.BJJ-2018-0470.R1

PMID: 30168769

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Abstract

Recurrent infection following two-stage revision total hip arthroplasty (THA) for prosthetic joint infection (PJI) is a devastating complication. The purpose of this study was to report the survival of repeat two-stage revision hip arthroplasty, describe complications, and identify risk factors for failure. We retrospectively identified 19 hips (19 patients) that had undergone repeat two-stage revision THA for infection between 2000 to 2013. There were seven female patients (37%) and the mean age was 60 years (30 to 85). Survival free from revision was assessed via Kaplan-Meier analysis. The patients were classified according to the Musculoskeletal Infection Society (MSIS) system, and risk factors for failure were identified. Mean follow-up was four years (2 to 11). Gram-positive bacteria were responsible for 16/17 (94%) of the re-infections where microbes were identified. Following the repeat two-stage exchange arthroplasty, survival free from any revision was 74% (95% confidence interval (CI) 56% to 96%, 14 at risk) at two years and 45% (95% CI 25% to 75%, five at risk) at five years. Failure to control infection resulted in re-operation or revision in 42%A of patients (8/19). Survival free from revision was not dependent on host grade. Re-infection after two-stage exchange hip arthroplasty for PJI presents a challenging scenario. Repeat two-stage exchange arthroplasty has a low survival free from revision at five years (45%) and a high rate of re-infection (42%). Cite this article: Bone Joint J 2018;100-B:1157-61.

Humans

Middle Aged

Risk Factors

Kaplan-Meier Estimate

Hip Prosthesis - adverse effects

Prosthesis-Related Infections - etiology

Male

Treatment Outcome

Arthroplasty, Replacement, Hip - adverse effects

Arthroplasty, Replacement, Hip - methods

Prosthesis-Related Infections - surgery

Reoperation - methods

Aged, 80 and over

Adult

Female

Reoperation - adverse effects

Aged

Retrospective Studies

Details

Title: Subtitle: Repeat two-stage exchange arthroplasty for prosthetic hip re-infection
Creators: T S Brown - University of Iowa, Iowa City, Iowa, USA
K A Fehring - OrthoCarolina, Charlotte, North Carolina, USA
M Ollivier - Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
T M Mabry - Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
A D Hanssen - Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
M P Abdel - Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
Resource Type: Journal article
Publication Details: The bone & joint journal, Vol.100-B(9), pp.1157-1161
DOI: 10.1302/0301-620X.100B9.BJJ-2018-0470.R1
PMID: 30168769
NLM abbreviation: Bone Joint J
ISSN: 2049-4394
eISSN: 2049-4408
Publisher: England
Language: English
Date published: 09/2018
Academic Unit: Orthopedics and Rehabilitation
Record Identifier: 9984040238802771

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