One-stage revision arthroplasty for management of periprosthetic hip infection

Ermakov A.M., Kliushin N.M., Ababkov I.V., Triapichnikov A.S., Koiushkov A.N.

Abstract


Background
One-stage revision arthroplasty has currently a limited use in treatment of a periprosthetic infection despite obvious economic benefits in comparison with two-stage revisions. This operation involves the removal of all implant components, radical surgical debridement, joint irrigation, installation of a new implant, and a long course of antibiotic therapy.
Purpose
To evaluate the effectiveness of one-stage revision arthroplasty in the treatment of patients with periprosthetic infection of the hip joint.
Material and methods
Results of treatment of 14 patients with periprosthetic hip infection who underwent the procedure of a single-stage revision arthroplasty in the period from 2009 to 2018 were analyzed. The average follow-up was 2.7 years (range, 1 to 10 years).
Results
Twelve (86 %) out of 14 patients with periprosthetic infection of the hip joint completed one-stage treatment successfully. Two (14 %) patients developed recurrent infection and had a two-stage revision arthroplasty using an antibacterial spacer. In accordance with the Harris Hip Score scale, the functional state of the limbs at a one-years follow-up after treatment averaged 77.7 points (range, 36 to 95).
Conclusions
One-stage revision is quite a laborious medical procedure, for which sufficient experience of orthopedic surgeons and a specialized hospital service. This method of treatment provided suppression of infection in 86 % of our cases. Negative factors in using one-stage revision were polymicrobial infection and implant dislocation in the early postoperative period.

Keywords


arthroplasty, hip, periprosthetic infection, treatment, one stage revision

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DOI: http://dx.doi.org/10.18019/1028-4427-2019-25-2-172-179

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