CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(05): e781-e789
DOI: 10.1055/s-0043-1776132
Artigo Original
Quadril

Comparison of Surgical Procedures in the Treatment of Hip Periprosthetic Infection

Article in several languages: português | English
1   Médico ortopedista e Traumatologista, Serviço de Ortopedia e Traumatologia, Unidade Local de Saúde Alto Minho, Viana do Castelo, Portugal
,
2   Médico ortopedista e Traumatologista, Serviço de Ortopedia e Traumatologia, Hospital de Braga, Braga, Portugal
› Author Affiliations
Financial Support The present research received no specific funding from public, commercial, or not-for-profit sector agencies.

Abstract

Objective The present study aimed to compare the cure rate recovery time and Merle d'Aubigné-Postel functional (MAPF) score after single-stage surgery (C1T) or two-stage surgery (C2T) to treat prosthetic infections of the hip considering sociodemographic and clinical features of the patients.

Materials and Methods The present retrospective study occurred in a single center from 2011 to 2014 with 37 studied cases including 26 treated with C1T and 11 with C2T. We compared the cure rate recovery time and MAPF score in the two groups as well as the sociodemographic and clinical features of the patients. We also considered surgical complications and the most common infectious agents.

Results The C1T group had a faster functional recovery than the C2T group but there were no significant differences in the cure rate surgical complications or MAPF score. However C1T group patients were significantly younger which may have influenced the outcomes. Staphylococcus spp. was the most common infectious agent (62%).

Conclusion Although C2T appears superior regarding infection cure C1T may be preferable for faster functional recovery. However it is critical to consider individual patient characteristics when choosing treatment. Further research with a larger sample size is required to confirm these results.

Work developed at the Orthopedic and Traumatology Service, Alto Minho Local Health Unit, Viana do Castelo, Portugal.




Publication History

Received: 19 March 2023

Accepted: 05 May 2023

Article published online:
30 October 2023

© 2023. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • Referências

  • 1 Illingworth KD, Mihalko WM, Parvizi J, Sculco T, McArthur B, el Bitar Y, Saleh KJ. How to minimize infection and thereby maximize patient outcomes in total joint arthroplasty: a multicenter approach: AAOS exhibit selection. J Bone Joint Surg Am 2013; 95 (08) e50
  • 2 Pivec R, Johnson AJ, Mears SC, Mont MA. Hip arthroplasty. Lancet 2012; 380 (9855): 1768-1777
  • 3 Baek SH. Identification and preoperative optimization of risk factors to prevent periprosthetic joint infection. World J Orthop 2014; 5 (03) 362-367
  • 4 Del Pozo JL, Patel R. Clinical practice. Infection associated with prosthetic joints. N Engl J Med 2009; 361 (08) 787-794
  • 5 Bozic KJ, Kurtz SM, Lau E, Ong K, Vail TP, Berry DJ. The epidemiology of revision total hip arthroplasty in the United States. J Bone Joint Surg Am 2009; 91 (01) 128-133
  • 6 Dale H, Fenstad AM, Hallan G, Havelin LI, Furnes O, Overgaard S. et al. Increasing risk of prosthetic joint infection after total hip arthroplasty. Acta Orthop 2012; 83 (05) 449-458
  • 7 Oussedik S, Gould K, Stockley I, Haddad FS. Defining peri-prosthetic infection: do we have a workable gold standard?. J Bone Joint Surg Br 2012; 94 (11) 1455-1456
  • 8 Wolf M, Clar H, Friesenbichler J, Schwantzer G, Bernhardt G, Gruber G. et al. Prosthetic joint infection following total hip replacement: results of one-stage versus two-stage exchange. Int Orthop 2014; 38 (07) 1363-1368
  • 9 Zimmerli W, Trampuz A, Ochsner PE. Prosthetic-joint infections. N Engl J Med 2004; 351 (16) 1645-1654
  • 10 Lange J, Troelsen A, Thomsen RW, Søballe K. Chronic infections in hip arthroplasties: comparing risk of reinfection following one-stage and two-stage revision: a systematic review and meta-analysis. Clin Epidemiol 2012; 4: 57-73
  • 11 Chen SY, Hu CC, Chen CC, Chang YH, Hsieh PH. Two-stage revision arthroplasty for periprosthetic hip infection: Mean follow-up of ten years. BioMed Res Int 2015; 2015: 345475
  • 12 Hernigou P, Flouzat-Lachianette CH, Jalil R, Uirassu Batista S, Guissou I, Poignard A. Treatment of infected hip arthroplasty. Open Orthop J 2010; 4: 126-131
  • 13 Bori G, Muñoz-Mahamud E, Cuñé J, Gallart X, Fuster D, Soriano A. One-stage revision arthroplasty using cementless stem for infected hip arthroplasties. J Arthroplasty 2014; 29 (05) 1076-1081
  • 14 Hsieh PH, Huang KC, Lee PC, Lee MS. Two-stage revision of infected hip arthroplasty using an antibiotic-loaded spacer: retrospective comparison between short-term and prolonged antibiotic therapy. J Antimicrob Chemother 2009; 64 (02) 392-397
  • 15 Osmon DR, Berbari EF, Berendt AR, Lew D, Zimmerli W, Steckelberg JM. et al; Infectious Diseases Society of America. Diagnosis and management of prosthetic joint infection: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis 2013; 56 (01) e1-e25
  • 16 Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987; 40 (05) 373-383
  • 17 D'Aubigne RM, Postel M. Functional results of hip arthroplasty with acrylic prosthesis. J Bone Joint Surg Am 1954; 36-A (03) 451-475
  • 18 Mahomed NN, Barrett JA, Katz JN, Phillips CB, Losina E, Lew RA. et al. Rates and outcomes of primary and revision total hip replacement in the United States medicare population. J Bone Joint Surg Am 2003; 85 (01) 27-32
  • 19 Bosco JA, Catanzano AJ, Stachel AG, Phillips MS. Prince Rainier R Tejada. Expanded gram-negative antimicrobial prophylaxis reduces surgical site infections in hip arthroplasty. J Arthroplasty 2016; 31 (03) 616-621
  • 20 Stockley I, Mockford BJ, Hoad-Reddick A, Norman P. The use of two-stage exchange arthroplasty with depot antibiotics in the absence of long-term antibiotic therapy in infected total hip replacement. J Bone Joint Surg Br 2008; 90 (02) 145-148
  • 21 Hoberg M, Konrads C, Engelien J, Oschmann D, Holder M, Walcher M. et al. Similar outcomes between two-stage revisions for infection and aseptic hip revisions. Int Orthop 2016; 40 (03) 459-464
  • 22 Reina N, Delaunay C, Chiron P, Ramdane N, Hamadouche M. Société française de chirurgie orthopédique et traumatologique. Infection as a cause of primary total hip arthroplasty revision and its predictive factors. Orthop Traumatol Surg Res 2013; 99 (05) 555-561
  • 23 Choong PF, Dowsey MM, Carr D, Daffy J, Stanley P. Risk factors associated with acute hip prosthetic joint infections and outcome of treatment with a rifampinbased regimen. Acta Orthop 2007; 78 (06) 755-765
  • 24 Kunutsor SK, Whitehouse MR, Blom AW, Beswick AD. INFORM Team. Re-infection outcomes following one- and two-stage surgical revision of infected hip prosthesis: A systematic review and meta-analysis. PLoS One 2015; 10 (09) e0139166
  • 25 Urquhart DM, Hanna FS, Brennan SL, Wluka AE, Leder K, Cameron PA. et al. Incidence and risk factors for deep surgical site infection after primary total hip arthroplasty: a systematic review. J Arthroplasty 2010; 25 (08) 1216-22.e1 , 3
  • 26 Liu K, Zheng J, Jin Y, Zhao YQ. Application of temporarily functional antibiotic-containing bone cement prosthesis in revision hip arthroplasty. Eur J Orthop Surg Traumatol 2014; 24 (01) 51-55
  • 27 Kelm J, Bohrer P, Schmitt E, Anagnostakos K. Treatment of proximal femur infections with antibiotic-loaded cement spacers. Int J Med Sci 2009; 6 (05) 258-264
  • 28 de Dios M, Cordero-Ampuero J. [Risk factors for infection in total knee artrhoplasty, including previously unreported intraoperative fracture and deep venous thrombosis]. Rev Esp Cir Ortop Traumatol 2015; 59 (01) 36-43
  • 29 Gehrke T, Kendoff D. Peri-prosthetic hip infections: in favour of one-stage. Hip Int 2012; 22 (Suppl. 08) S40-S45
  • 30 Joulie D, Girard J, Mares O, Beltrand E, Legout L, Dezèque H. et al. Factors governing the healing of Staphylococcus aureus infections following hip and knee prosthesis implantation: a retrospective study of 95 patients. Orthop Traumatol Surg Res 2011; 97 (07) 685-692