Treatment Failure Among Infected Periprosthetic Total Hip Arthroplasty Patients
Ran Schwarzkopf*, 1, Bassem Mikhael 2, Elizabeth Wright 3, Daniel M Estok, II2, Jeffrey N Katz 3
Identifiers and Pagination:Year: 2014
First Page: 118
Last Page: 124
Publisher Id: TOORTHJ-8-118
Article History:Received Date: 1/1/2014
Revision Received Date: 6/5/2014
Acceptance Date: 10/5/2014
Electronic publication date: 30/5/2014
Collection year: 2014
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/) which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.
Two-stage revision has been shown to be the most successful treatment in eradicating deep infection following total hiparthroplasty. We identified 62 patients treated by a two-stage revision. We defined “successful revision” as negative intraoperative cultures and no further infection-related procedure. We defined “eradication of infection” on the basis of negative cultures and clinical diagnosis at least one year after 2nd stage procedure. After a mean follow up of 2.7 years, eradication of the infection was documented in 91.1%, and a successful two-stage revision in 85.7% of patients. We observed no association between higher pre-reimplantation levels of ESR and C-reactive protein and lower likelihood of successful two-stage revision. We found an association between a history of another previous infected prosthetic joint and a failed 2nd stage procedure. Failure to achieve eradication of infection and successful two-stage revision occurs infrequently. Patients with prior history of a previous prosthetic joint infection are at higher risk of failure.