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International Orthopaedics

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01-03-2020 | Wound Debridement | Original Paper

Partial implant retention in two-stage exchange for chronic infected total hip arthroplasty

Authors: Xiaojun Shi, Jing Yang, Zongke Zhou, Bin Shen, Pengde Kang, Fuxing Pei

Published in: International Orthopaedics | Issue 3/2020

Abstract

Background

The efficacy of partial retention of well-fixed components during two-stage exchange for chronic total hip arthroplasty (THA) infection has remained unknown.

Methods

A total of 14 patients with chronic infected THA were treated with damage control two-stage revision, including selective retention of the well-fixed femoral or acetabular component, aggressive debridement, antibiotic-laden cement spacer, antibiotic therapy, and delayed reimplantation. Indications for this treatment included chronic infected THAs with ingrown femoral or acetabular component and positive microbial growth with sensitive antibiotics. We excluded patients with acute infection; negative microbial growth; positive pathogen with high-virulence bacterial infections and multiple drug-resistant bacteria such as methicillin-resistant Staphylococcus aureus, fungi, and Mycobacterium tuberculosis; sinus formation; a prior failure for periprosthetic joint infection (PJI) treatment; and obvious bone resorption in both femoral and acetabulum side. During the study period, this represented 3.3% (14/425) of the patients treated for infected THA. Minimum follow-up was three years. None of the 14 patients in this series were lost to follow-up. Successful treatment was defined according to a modified Delphi-based international multidisciplinary consensus.

Results

No repeated debridement and recurrence of infection occurred during the study period; no patient need chronic antibiotic suppression. Successful treatment of chronic PJI was achieved in all patients. Despite the high peri-operative complication rate, no severe consequences were observed. The mean Harris Hip Score was 86 (range, 82–92; SD, 3.3).

Conclusions

The selective partial implant retention two-stage revision for chronic PJI may be a treatment option in properly selected patients with low virulence bugs.

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Title: Partial implant retention in two-stage exchange for chronic infected total hip arthroplasty
Authors: Xiaojun Shi
Jing Yang
Zongke Zhou
Bin Shen
Pengde Kang
Fuxing Pei
Publication date: 01-03-2020
Publisher: Springer Berlin Heidelberg
Keywords: Wound Debridement
Antibiotic
Joint Infection
Hip-TEP
Hip-TEP
Published in: International Orthopaedics / Issue 3/2020
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-019-04473-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Partial implant retention in two-stage exchange for chronic infected total hip arthroplasty

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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Acknowledgement for our reviewers