Is two-stage reimplantation effective for virulent pathogenic infection in a periprosthetic hip? A retrospective analysis
- Authors
- Yoon, Yong-Cheol; Lakhotia, Devendra; Oh, Jong-Keon; Moon, Jun Gyu; Prashant, Kumar; Shon, Won Yong
- Issue Date
- 18-Oct-2015
- Publisher
- BAISHIDENG PUBLISHING GROUP INC
- Keywords
- Two-stage reimplantation; Periprosthetic infection; Antibiotic-loaded bone cement; Debridement
- Citation
- WORLD JOURNAL OF ORTHOPEDICS, v.6, no.9, pp.712 - 718
- Journal Title
- WORLD JOURNAL OF ORTHOPEDICS
- Volume
- 6
- Number
- 9
- Start Page
- 712
- End Page
- 718
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/10029
- DOI
- 10.5312/wjo.v6.i9.712
- ISSN
- 2218-5836
- Abstract
- AIM: To investigate the effectiveness of two-stage reimplantation using antibiotic-loaded bone cement (ALBC) and the risk factors associated with failure to control periprosthetic joint infection (PJI). METHODS: We retrospectively reviewed 38 consecutive hips managed using two-stage reimplantation with ALBC. The mean follow-up period was 5.4 years (range: 2.5-9 years). RESULTS: The causative pathogens were isolated from 29 patients (76%), 26 of whom were infected with highly virulent organisms. Sixteen patients (42%) underwent at least two first-stage debridements. An increased debridement frequency correlated significantly with high comorbidity (P < 0.001), a lower preoperative Harris hip score (HHS; P < 0.001), antimicrobial resistance, and gram-negative and polymicrobial infection (P = 0.002). Of the 35 patients who underwent two-stage reimplantation, 34 showed no signs of recurrence of infection. The mean HHS improved from 46 +/- 12.64 to 78 +/- 10.55 points, with 7 (20%), 12 (34%), 11 (32%) and 5 (14%) patients receiving excellent, good, fair and poor ratings, respectively. CONCLUSION: The current study demonstrated that two-stage reimplantation could successfully treat PJI after hip arthroplasty. However, the ability of ALBC to eradicate infection was limited because frequent debridement was required in high-risk patients (i.e., patients who are either in poor general health due to associated comorbidities or harbor infections due to highly virulent, difficult-to-treat organisms). Level of evidence: Level IV.
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Collections - 의과대학 > 의학과 > 1. Journal Articles
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