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Open Access 01-12-2017 | Original Paper

The influence of antibiotic-loaded cement spacers on the risk of reinfection after septic two-stage hip revision surgery

Authors: Kevin Staats, Florian Sevelda, Alexandra Kaider, Christoph Böhler, Irene K. Sigmund, Stephan E. Puchner, Reinhard Windhager, Johannes Holinka

Published in: Infection | Issue 6/2017

Abstract

Purpose

The aim of this study was the evaluation of possible outcome differences of patients undergoing two-stage hip exchange with antibiotic-loaded spacers, compared to patients without an interim spacer implantation.

Methods

We evaluated 46 patients undergoing two-stage hip revision surgery. Twenty-five patients received an interim ALS. Additional to a Kaplan–Meier survival analysis, a competing risk analysis was performed to estimate the cumulative incidence function for re-revisions due to infection accounting for death as a competing event.

Results

Nine patients (seven non-ALS vs. two ALS) had to undergo re-revision surgery due to reinfection of the hip joint. The non-ALS group showed a risk of re-revision of 19% (95% CI 5–38%) at 12 and 24 months and 30% (95% CI 12–51%) at 36 months. The group with ALS implantation displayed a 0% risk of re-revision surgery in the first 36 months. The Gray test revealed a significant difference in the cumulative incidence between both observed groups (p = 0.026).

Conclusion

Our findings suggest that ALS implantation significantly reduces the risk of reinfection after two-stage hip revision surgery.

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Title: The influence of antibiotic-loaded cement spacers on the risk of reinfection after septic two-stage hip revision surgery
Authors: Kevin Staats
Florian Sevelda
Alexandra Kaider
Christoph Böhler
Irene K. Sigmund
Stephan E. Puchner
Reinhard Windhager
Johannes Holinka
Publication date: 01-12-2017
Publisher: Springer Berlin Heidelberg
Published in: Infection / Issue 6/2017
Print ISSN: 0300-8126
Electronic ISSN: 1439-0973
DOI: https://doi.org/10.1007/s15010-017-1081-5

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