Skip to main content
Top
Published in: European Journal of Orthopaedic Surgery & Traumatology 3/2008

01-04-2008 | Original Article

Two-stage hip revision arthroplasty: the role of the excision arthroplasty

Authors: Bergita Ganse, Peter Behrens, Jan Philipp Benthien

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 3/2008

Login to get access

Abstract

Between 1995 and 2003, 41 septic hips in 40 consecutive patients (20 males, 20 females) were treated with a two-stage total-hip-arthroplasty revision. Seventeen patients with 18 relevant procedures (44%) were reviewed at a mean follow-up of 52 months. In 5 hips, an excision arthroplasty was present at review. Reimplantation had been performed in 13 hips. The interval between explantation and reimplantation averaged 158 days. The average age was 68 years and the mean ASA score 3.24 at explantation. Mean Harris Hip score was 60 points, the mean Mayo Hip Score 66 points. We found no significance (Harris Hip Score, t test) between results after reimplantation and with long-term excision arthroplasty. The excision arthroplasty as a long-term solution can be an alternative to reimplantation in the treatment of critically ill patients.
Literature
1.
go back to reference Bittar ES, Petty W (1982) Girdlestone arthroplasty for infected total hip arthroplasty. Clin Orthop Relat Res 170:83–87PubMed Bittar ES, Petty W (1982) Girdlestone arthroplasty for infected total hip arthroplasty. Clin Orthop Relat Res 170:83–87PubMed
2.
go back to reference Bourne RB, Hunter GA, Rorabeck CH, Macnab JJ (1984) A six-year follow-up of infected total hip replacements managed by Girdlestone’s arthroplasty. J Bone Joint Surg Br 66(3):340–343PubMed Bourne RB, Hunter GA, Rorabeck CH, Macnab JJ (1984) A six-year follow-up of infected total hip replacements managed by Girdlestone’s arthroplasty. J Bone Joint Surg Br 66(3):340–343PubMed
3.
go back to reference Fehring TK, Calton TF, Griffin WL (1999) Cementless fixation in 2-stage reimplantation for periprosthetic sepsis. J Arthroplasty 14(2):175–181PubMedCrossRef Fehring TK, Calton TF, Griffin WL (1999) Cementless fixation in 2-stage reimplantation for periprosthetic sepsis. J Arthroplasty 14(2):175–181PubMedCrossRef
4.
go back to reference [No authors] (1982) The classic. Acute pyogenic arthritis of the hip: an operation giving free access and effective drainage. G. R. Girdlestone 1943. Clin Orthop Oct (170):3–7 [No authors] (1982) The classic. Acute pyogenic arthritis of the hip: an operation giving free access and effective drainage. G. R. Girdlestone 1943. Clin Orthop Oct (170):3–7
5.
go back to reference Grauer JD, Amstutz HC, O’Carroll PF, Dorey FJ (1989) Resection arthroplasty of the hip. J Bone Joint Surg Am 71-A:669–678 Grauer JD, Amstutz HC, O’Carroll PF, Dorey FJ (1989) Resection arthroplasty of the hip. J Bone Joint Surg Am 71-A:669–678
6.
go back to reference Haddad FS, Muirhead-Allwood SK, Manktelow ARJ, Bacarese-Hamilton I (2000) Two-stage uncemented revision hip arthroplasty for infection. J Bone Joint Surg Br 82-B:689–694CrossRef Haddad FS, Muirhead-Allwood SK, Manktelow ARJ, Bacarese-Hamilton I (2000) Two-stage uncemented revision hip arthroplasty for infection. J Bone Joint Surg Br 82-B:689–694CrossRef
7.
go back to reference Hanssen AD, Osmon DR, Nelson CL (1996) Prevention of deep periprosthetic joint infection. J Bone Joint Surg Am 78-A:458–471 Hanssen AD, Osmon DR, Nelson CL (1996) Prevention of deep periprosthetic joint infection. J Bone Joint Surg Am 78-A:458–471
8.
go back to reference Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty: an end-result study using a new method of result evaluation. J Bone Joint Surg Am 51-A:737–755 Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty: an end-result study using a new method of result evaluation. J Bone Joint Surg Am 51-A:737–755
9.
go back to reference Ilyas I, Morgan DAF (2001) Massive structural allograft in revision of septic hip arthroplasty. Int Orthop 24(6):319–322PubMedCrossRef Ilyas I, Morgan DAF (2001) Massive structural allograft in revision of septic hip arthroplasty. Int Orthop 24(6):319–322PubMedCrossRef
10.
go back to reference Jenny J-Y, Jenny G, Lambert J, Gaudias J, Kempf I (1994) Gentamicin PMMA beads in management of bone and joint infections. Orthop Traumatol 4:101–104CrossRef Jenny J-Y, Jenny G, Lambert J, Gaudias J, Kempf I (1994) Gentamicin PMMA beads in management of bone and joint infections. Orthop Traumatol 4:101–104CrossRef
11.
go back to reference Karpaš K, Šponer P (2003) Management of the infected hip arthroplasty by two-stage reimplantation. Acta Medica (Hradec Králové) 46(3):113–115 Karpaš K, Šponer P (2003) Management of the infected hip arthroplasty by two-stage reimplantation. Acta Medica (Hradec Králové) 46(3):113–115
12.
go back to reference Kavanagh BF, Fitzgerald RH Jr (1985) Clinical and roentgenographic assessment of total hip arthroplasty: a new hip score. Clin Orthop Relat Res 193:133–140PubMed Kavanagh BF, Fitzgerald RH Jr (1985) Clinical and roentgenographic assessment of total hip arthroplasty: a new hip score. Clin Orthop Relat Res 193:133–140PubMed
13.
go back to reference Liebermann JR, Callaway GH, Salvati EA, Pellicci PM, Brause BD (1994) Treatment of the infected total hip arthroplasty with a two-stage reimplantation protocol. Clin Orthop Relat Res 301:205–212 Liebermann JR, Callaway GH, Salvati EA, Pellicci PM, Brause BD (1994) Treatment of the infected total hip arthroplasty with a two-stage reimplantation protocol. Clin Orthop Relat Res 301:205–212
14.
go back to reference McElwaine JP, Colville J (1984) Excisional arthroplasty for infected total hip replacements. J Bone Joint Surg Br 66-B:168–171 McElwaine JP, Colville J (1984) Excisional arthroplasty for infected total hip replacements. J Bone Joint Surg Br 66-B:168–171
15.
go back to reference Morscher E, Herzog R, Bapst R (1994) Hip revision surgery in septic loosening. Chir Organi Mov 79(4):335–340PubMed Morscher E, Herzog R, Bapst R (1994) Hip revision surgery in septic loosening. Chir Organi Mov 79(4):335–340PubMed
16.
go back to reference Ridgeway S, Wilson J, Charlet A, Kafatos G, Pearson A, Coello R (2004) Infection of the surgical site after arthroplasty of the hip. J Bone Joint Surg Br 87-B:844–850 Ridgeway S, Wilson J, Charlet A, Kafatos G, Pearson A, Coello R (2004) Infection of the surgical site after arthroplasty of the hip. J Bone Joint Surg Br 87-B:844–850
17.
go back to reference Rittmeister ME, Manthei L, Hailer NP (2005) Prosthetic replacement in secondary Girdlestone arthroplasty has an unpredictable outcome. Int Orthop 28(3):145–148CrossRef Rittmeister ME, Manthei L, Hailer NP (2005) Prosthetic replacement in secondary Girdlestone arthroplasty has an unpredictable outcome. Int Orthop 28(3):145–148CrossRef
18.
go back to reference Schröder J, Saris D, Besselaar PP, Marti RK (1998) Comparison of the results of the Girdlestone pseudarthrosis with reimplantation of a total hip replacement. Int Orthop 22:215–218PubMedCrossRef Schröder J, Saris D, Besselaar PP, Marti RK (1998) Comparison of the results of the Girdlestone pseudarthrosis with reimplantation of a total hip replacement. Int Orthop 22:215–218PubMedCrossRef
19.
go back to reference Younger AS, Duncan CP, Masri BA, McGraw RW (1997) The outcome of two-stage arthroplasty using custom-made interval spacer to treat the infected hip. J Arthroplasty 12(6):615–623PubMedCrossRef Younger AS, Duncan CP, Masri BA, McGraw RW (1997) The outcome of two-stage arthroplasty using custom-made interval spacer to treat the infected hip. J Arthroplasty 12(6):615–623PubMedCrossRef
Metadata
Title
Two-stage hip revision arthroplasty: the role of the excision arthroplasty
Authors
Bergita Ganse
Peter Behrens
Jan Philipp Benthien
Publication date
01-04-2008
Publisher
Springer-Verlag
Published in
European Journal of Orthopaedic Surgery & Traumatology / Issue 3/2008
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-007-0290-5

Other articles of this Issue 3/2008

European Journal of Orthopaedic Surgery & Traumatology 3/2008 Go to the issue

Book Reviews

Recent literature