Skip to main content
Top
Published in: HSS Journal ® 1/2017

01-02-2017 | Evidence Based Review in Orthopedics

Poor Prognosis of Patients Treated for Periprosthetic Joint Infection

Authors: Cynthia A. Kahlenberg, MD, Alexia Hernandez-Soria, MD, Michael B. Cross, MD

Published in: HSS Journal ® | Issue 1/2017

Login to get access

Abstract

The study by Gomez et al., “The Fate of Spacers in the Treatment of Periprosthetic Joint Infection,” evaluates the clinical course and success rate of treatment of periprosthetic joint infection with two-stage revision with spacer placement in the interim period. The current review critically analyzes the findings of this study and examines how these findings may influence patient care in the field of hip and knee replacement. Gomez et al. report sobering results of two-stage revision with spacer placement for periprosthetic joint infection. Nearly 20% of patients in their study who had a spacer placed never went on to get a new prosthesis and nearly 20% of those who did get a new prosthesis ultimately failed treatment. The authors reported a 7.5% mortality rate in the interstage period after resection arthroplasty. This study provides valuable information for counseling patients about the outcomes of treatment using spacers for infection after total joint arthroplasty. The results of this study also highlight the need for future investigation into better treatments for periprosthetic joint infections.
Appendix
Available only for authorised users
Literature
1.
go back to reference AAOS. The diagnosis of periprosthetic joint infections of the hip and knee: guideline and evidence report. Rosemont: AAOS; 2010: 277. AAOS. The diagnosis of periprosthetic joint infections of the hip and knee: guideline and evidence report. Rosemont: AAOS; 2010: 277.
2.
go back to reference Berend KR, Lombardi AV Jr, Morris MJ, et al. Two-stage treatment of hip periprosthetic joint infection is associated with a high rate of infection control but high mortality. Clin Orthop Relat Res. 2013; 471: 510-518.CrossRefPubMed Berend KR, Lombardi AV Jr, Morris MJ, et al. Two-stage treatment of hip periprosthetic joint infection is associated with a high rate of infection control but high mortality. Clin Orthop Relat Res. 2013; 471: 510-518.CrossRefPubMed
3.
go back to reference Boettner F, Cross MB, Nam D, et al. Functional and emotional results differ after aseptic vs septic revision hip arthroplasty. HSS J. 2011; 7: 235-238.CrossRefPubMedPubMedCentral Boettner F, Cross MB, Nam D, et al. Functional and emotional results differ after aseptic vs septic revision hip arthroplasty. HSS J. 2011; 7: 235-238.CrossRefPubMedPubMedCentral
4.
go back to reference Gomez MM, Tan TL, Manrique J, et al. The fate of spacers in the treatment of periprosthetic joint infection. J Bone Joint Surg Am. 2015; 97: 1495-1502.CrossRefPubMed Gomez MM, Tan TL, Manrique J, et al. The fate of spacers in the treatment of periprosthetic joint infection. J Bone Joint Surg Am. 2015; 97: 1495-1502.CrossRefPubMed
5.
go back to reference Haddad FS, Sukeik M, Alazzawi S. Is single-stage revision according to a strict protocol effective in treatment of chronic knee arthroplasty infections? Clin Orthop Relat Res. 2015; 473: 8-14.CrossRefPubMed Haddad FS, Sukeik M, Alazzawi S. Is single-stage revision according to a strict protocol effective in treatment of chronic knee arthroplasty infections? Clin Orthop Relat Res. 2015; 473: 8-14.CrossRefPubMed
6.
go back to reference Hanssen AD. CORR Insights(R): is single-stage revision according to a strict protocol effective in treatment of chronic knee arthroplasty infections? Clin Orthop Relat Res. 2015; 473: 15-16.CrossRefPubMed Hanssen AD. CORR Insights(R): is single-stage revision according to a strict protocol effective in treatment of chronic knee arthroplasty infections? Clin Orthop Relat Res. 2015; 473: 15-16.CrossRefPubMed
8.
go back to reference Hsieh PH, Shih CH, Chang YH, et al. Two-stage revision hip arthroplasty for infection: comparison between the interim use of antibiotic-loaded cement beads and a spacer prosthesis. J Bone Joint Surg Am. 2004; 86-A: 1989-1997.CrossRefPubMed Hsieh PH, Shih CH, Chang YH, et al. Two-stage revision hip arthroplasty for infection: comparison between the interim use of antibiotic-loaded cement beads and a spacer prosthesis. J Bone Joint Surg Am. 2004; 86-A: 1989-1997.CrossRefPubMed
9.
go back to reference Ilchmann T, Zimmerli W, Ochsner PE, et al. One-stage revision of infected hip arthroplasty: outcome of 39 consecutive hips. Int Orthop. 2015. Ilchmann T, Zimmerli W, Ochsner PE, et al. One-stage revision of infected hip arthroplasty: outcome of 39 consecutive hips. Int Orthop. 2015.
11.
go back to reference Kurtz SM, Lau E, Watson H, et al. Economic burden of periprosthetic joint infection in the United States. J Arthroplast. 2012; 27: 61-65. e61.CrossRef Kurtz SM, Lau E, Watson H, et al. Economic burden of periprosthetic joint infection in the United States. J Arthroplast. 2012; 27: 61-65. e61.CrossRef
12.
go back to reference Macheras GA, Kateros K, Galanakos SP, et al. The long-term results of a two-stage protocol for revision of an infected total knee replacement. J Bone Joint Surg Br Vol. 2011; 93: 1487-1492.CrossRef Macheras GA, Kateros K, Galanakos SP, et al. The long-term results of a two-stage protocol for revision of an infected total knee replacement. J Bone Joint Surg Br Vol. 2011; 93: 1487-1492.CrossRef
13.
go back to reference Parvizi J, Adeli B, Zmistowski B, et al. Management of periprosthetic joint infection: the current knowledge: AAOS exhibit selection. J Bone Joint Surg Am. 2012; 94: e104.CrossRefPubMed Parvizi J, Adeli B, Zmistowski B, et al. Management of periprosthetic joint infection: the current knowledge: AAOS exhibit selection. J Bone Joint Surg Am. 2012; 94: e104.CrossRefPubMed
14.
go back to reference Pivec R, Naziri Q, Issa K, et al. Systematic review comparing static and articulating spacers used for revision of infected total knee arthroplasty. J Arthroplast. 2014; 29: 553-557. e551.CrossRef Pivec R, Naziri Q, Issa K, et al. Systematic review comparing static and articulating spacers used for revision of infected total knee arthroplasty. J Arthroplast. 2014; 29: 553-557. e551.CrossRef
15.
go back to reference Toulson C, Walcott-Sapp S, Hur J, et al. Treatment of infected total hip arthroplasty with a 2-stage reimplantation protocol: update on “our institution’s” experience from 1989 to 2003. J Arthroplast. 2009; 24: 1051-1060.CrossRef Toulson C, Walcott-Sapp S, Hur J, et al. Treatment of infected total hip arthroplasty with a 2-stage reimplantation protocol: update on “our institution’s” experience from 1989 to 2003. J Arthroplast. 2009; 24: 1051-1060.CrossRef
16.
go back to reference Voleti PB, Baldwin KD, Lee GC. Use of static or articulating spacers for infection following total knee arthroplasty: a systematic literature review. J Bone Joint Surg Am. 2013; 95: 1594-1599.CrossRefPubMed Voleti PB, Baldwin KD, Lee GC. Use of static or articulating spacers for infection following total knee arthroplasty: a systematic literature review. J Bone Joint Surg Am. 2013; 95: 1594-1599.CrossRefPubMed
17.
go back to reference Volin SJ, Hinrichs SH, Garvin KL. Two-stage reimplantation of total joint infections: a comparison of resistant and non-resistant organisms. Clin Orthop Relat Res. 2004;94–100. Volin SJ, Hinrichs SH, Garvin KL. Two-stage reimplantation of total joint infections: a comparison of resistant and non-resistant organisms. Clin Orthop Relat Res. 2004;94–100.
18.
go back to reference Yamamoto K, Miyagawa N, Masaoka T, et al. Clinical effectiveness of antibiotic-impregnated cement spacers for the treatment of infected implants of the hip joint. J Orthop Sci. 2003; 8: 823-828.CrossRefPubMed Yamamoto K, Miyagawa N, Masaoka T, et al. Clinical effectiveness of antibiotic-impregnated cement spacers for the treatment of infected implants of the hip joint. J Orthop Sci. 2003; 8: 823-828.CrossRefPubMed
Metadata
Title
Poor Prognosis of Patients Treated for Periprosthetic Joint Infection
Authors
Cynthia A. Kahlenberg, MD
Alexia Hernandez-Soria, MD
Michael B. Cross, MD
Publication date
01-02-2017
Publisher
Springer US
Published in
HSS Journal ® / Issue 1/2017
Print ISSN: 1556-3316
Electronic ISSN: 1556-3324
DOI
https://doi.org/10.1007/s11420-016-9507-7

Other articles of this Issue 1/2017

HSS Journal ® 1/2017 Go to the issue