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International Orthopaedics

Published in:

01-05-2017 | Original Paper

Retention of the well-fixed implant in the single-stage exchange for chronic infected total hip arthroplasty: an average of five years of follow-up

Authors: Baochao Ji, Boyong Xu, Wentao Guo, Aili Rehei, Wenbo Mu, Desheng Yang, Li Cao

Published in: International Orthopaedics | Issue 5/2017

Abstract

Purpose

Removal of an infected prosthesis was considered the gold standard for eradication of infection. However, removal of well-fixed components can result in structural bone damage and compromised reconstruction. In these situations we questioned whether the infection after the total hip arthroplasty could be treated effectively and retain the well-fixed implant in a single-stage exchange.

Methods

A retrospective analysis which included 31 patients with chronic infected THA who underwent major partial single-stage revision, including routinely exchanged femoral head and liner components, aggressive soft tissue debridement, removal of the femoral stem or acetabular cup and retention of the well-fixed component, thorough exposed component brushing, and adequate surgical soaking. Powdered Vancomycin was poured into the surgical area and the infection control rate and clinical outcomes were evaluated. The failure to treat the infection was defined as a recurrence of infection in the same hip. The average follow-up was five years (2–15 years).

Result

There were four (12.9 %) failures during the study period at an average of 15 months (9–21 months) after partial single-stage revision. Of the 31 patients, 27 (87.1 %) patients had a satisfactory outcome and required no additional surgical or medical treatment for recurrence of infection. Acetabular cups were revised in 22 patients and femoral stems in nine patients. The mean post-operative Harris hip score at the most recent assessment was 74.6 (68–82).

Conclusions

Treatment of chronic infected THA with retention of the well-fixed implant in a single-stage exchange can be fairly effective in the treatment of infection and achieving acceptable functional outcomes, which indicated that this may be an attractive alternative in highly selected patients.

Level of Evidence: Level IV, therapeutic study.

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Title: Retention of the well-fixed implant in the single-stage exchange for chronic infected total hip arthroplasty: an average of five years of follow-up
Authors: Baochao Ji
Boyong Xu
Wentao Guo
Aili Rehei
Wenbo Mu
Desheng Yang
Li Cao
Publication date: 01-05-2017
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 5/2017
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-016-3291-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Retention of the well-fixed implant in the single-stage exchange for chronic infected total hip arthroplasty: an average of five years of follow-up

Abstract

Purpose

Methods

Result

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Result

Conclusions

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