Management of Periprosthetic Joint Infection following THA: The One-Stage Exchange

2017 ◽  
Author(s):  
AAOS at DKOU 2017
Keyword(s):  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
One Stage ◽  
The One

scholarly journals Efficiency of the One-Stage Revision Hip Arthroplasty in Chronic Periprosthetic Joint Infection with Sinus Tract

2021 ◽  
Vol 27 (2) ◽  
pp. 9-22
Author(s):  
V. A. Artyukh ◽  
S. A. Bozhkova ◽  
A. A. Boyarov ◽  
Ju. V. Muravyova ◽  
A. A. Kochish
Keyword(s):  
Hip Arthroplasty ◽  
Periprosthetic Joint Infection ◽  
Soft Tissues ◽  
Joint Infection ◽  
Sinus Tract ◽  
Revision Hip Arthroplasty ◽  
One Stage ◽  
Significant Difference ◽  
The One

Background. Chronic periprosthetic joint infection (PJI) remains the one among the most severe complications of total hip arthroplasty. Presence of sinus tract assosiated with polymicrobial infection development, complexity of bacteriological diagnostics  and  damage  of  soft  tissues  lead  to  constrictions  of  one-stage  revision  hip  arthroplasty  (RHA). The  aim of this studywas to assess the influence of draining sinus tract on the outcomes of one-stage RHA in patients with chronic hip PJI.Materials and Methods.A prospective cohort comparative study included 78 patients who underwent one-stage RHA in 2017-2020. Two groups were formed: 48 (61.54%) patients without sinus tract (WST) and 30 (38.45%) patients with sinus tract (ST).Results. The presence of a sinus tract significantly increased the duration of a one-stage RHA in groups of ST and WST (230 and 197.5 min respectively, p = 0.02), as well as blood loss (850 ml and 700 ml, respectively, p = 0.046). Sinus tract was a reliable symptom of soft tissue local infectious inflammation (86.67%, p = 0.00031), fasciitis (36.67%, p = 0.012), purulent cavity (66.67%, p = 0.00027). The structure of the pathogens was comparable. Monobacterial infections predominated in the WST group (82.98%) and in the ST group (77.78%, p = 0.08). In most cases staphylococci were isolated. The median follow-up was 20 months for both groups. The PJI was healed in 93.0% (n = 28) patients in WST group and 82.2% (n = 43) in ST PJI (p>0.05). Postoperative evaluation in the WST and ST groups: HHS 92 and 90 points (p = 0.79), EQ-5D-5L – 0.82 and 0.78 points (p = 0.84) respectively. The proportion of patients who were indicated revision surgery with no PJI association in the ST group exceeded this indicator more than twice according to the WST group — 25 and 11.62%, respectively (p>0.05).Conclusion.As a result of the study, there was no statistically significant difference between the outcomes of one-stage RHA in patients with and without sinus tract. Factors such as the anamnesis morbi, the soft tissues condition at the surgical site and the pathogenic microflora characteristics should be taken into account in order to achieve favourable outcomes of surgical treatment.

scholarly journals One-Stage Exchange Arthroplasty for Fistulizing Periprosthetic Joint Infection of the Hip: An Effective Strategy

2020 ◽  
Vol 7 ◽  
Author(s):  
Simon Marmor ◽  
Younes Kerroumi ◽  
Vanina Meyssonnier ◽  
Luc Lhotellier ◽  
Antoine Mouton ◽  
...  
Keyword(s):  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Effective Strategy ◽  
One Stage ◽  
Exchange Arthroplasty

Ten-Year Results Following One-Stage Septic Hip Exchange in the Management of Periprosthetic Joint Infection

2019 ◽  
Vol 34 (6) ◽  
pp. 1221-1226 ◽  
Author(s):  
Akos Zahar ◽  
Ianiv Klaber ◽  
Anne-Marie Gerken ◽  
Thorsten Gehrke ◽  
Matthias Gebauer ◽  
...  
Keyword(s):  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
One Stage

The treatment of periprosthetic joint infection: safety and efficacy of two stage versus one stage exchange arthroplasty

2020 ◽  
Vol 17 (3) ◽  
pp. 245-252 ◽  
Author(s):  
Joseph R. Palmer ◽  
Tejbir S. Pannu ◽  
Jesus M. Villa ◽  
Jorge Manrique ◽  
Aldo M. Riesgo ◽  
...  
Keyword(s):  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Stage Versus ◽  
Two Stage ◽  
Safety And Efficacy ◽  
One Stage ◽  
Exchange Arthroplasty

scholarly journals Improved treatment strategies can result in better outcomes following one-stage exchange surgery for MRSA periprosthetic joint infection

2020 ◽  
Vol 69 (8) ◽  
pp. 1100-1104
Author(s):  
Malte Ohlmeier ◽  
Sergei Filitarin ◽  
Giorgio Delgado ◽  
Jannik Frings ◽  
Hussein Abdelaziz ◽  
...  
Keyword(s):  
Revision Rate ◽  
Joint Infection ◽  
Treatment Strategies ◽  
Content Type ◽  
One Stage ◽  
Joint Infections ◽  
The Mean ◽  
The One ◽  
Final Cohort

Introduction. Periprosthetic joint infections caused by methicillin-resistant Staphylococcus aureus (MRSA-PJIs) are rare, with only a few studies reporting the treatment outcomes and even fewer reporting outcomes with one-stage exchange. Aim. This study aims to analyse the outcomes of one-stage exchange in the management of MRSA-PJIs. Methodology. Patients with MRSA-PJI of the hip and knee, who were treated with a one-stage exchange between 2001 and 2018 were enrolled in this study. The final cohort comprised of 29 patients, which included 23 hips and six knees. The mean follow-up was 5.3 years (1–9 years). Reinfection and complications rates after the one-stage exchange were analysed. Results. Overall infection control could be achieved in 93.1 % (27 out of 29 patients). The overall revision rate was 31.0% (9 patients), with three patients requiring an in-hospital revision (10.3 %). Six patients had to be revised after hospital discharge (20.7 %). Of the two reinfections, one had a growth of MRSA while the other was of methicillin-sensitive Staphyloccocus epidermidis. Conclusion. One-stage exchange surgery using current techniques could improve surgical outcomes with excellent results in the management of MRSA-PJIs.

Favourable outcomes of repeat one-stage exchange for periprosthetic joint infection of the hip

2022 ◽  
Vol 104-B (1) ◽  
pp. 27-33
Author(s):  
Emanuel F. Liechti ◽  
Michael E. Neufeld ◽  
Fernando Soto ◽  
Philip Linke ◽  
Sophia-Marlene Busch ◽  
...  
Keyword(s):  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Staging System ◽  
Musculoskeletal Infection ◽  
Free Survival ◽  
Revision Thas ◽  
One Stage ◽  
Kaplan Meier ◽  
Number Of Patients ◽  
Host Status

Aims One-stage exchange for periprosthetic joint infection (PJI) in total hip arthroplasty (THA) is gaining popularity. The outcome for a repeat one-stage revision THA after a failed one-stage exchange for infection remains unknown. The aim of this study was to report the infection-free and all-cause revision-free survival of repeat one-stage exchange, and to investigate the association between the Musculoskeletal Infection Society (MSIS) staging system and further infection-related failure. Methods We retrospectively reviewed all repeat one-stage revision THAs performed after failed one-stage exchange THA for infection between January 2008 and December 2016. The final cohort included 32 patients. The mean follow-up after repeat one-stage exchange was 5.3 years (1.2 to 13.0). The patients with a further infection-related failure and/or all-cause revision were reported, and Kaplan-Meier survival for these endpoints determined. Patients were categorized according to the MSIS system, and its association with further infection was analyzed. Results A total of eight repeat septic revisions (25%) developed a further infection-related failure, and the five-year infection-free survival was 81% (95% confidence interval (CI) 57 to 92). Nine (28%) underwent a further all-cause revision and the five-year all-cause revision-free survival was 74% (95% CI 52 to 88). Neither the MSIS classification of the host status (p = 0.423) nor the limb status (p = 0.366) was significantly associated with further infection-related failure. Conclusion Repeat one-stage exchange for PJI in THA is associated with a favourable five-year infection-free and all-cause revision-free survival. Notably, the rate of infection control is encouraging when compared with the reported rates after repeat two-stage exchange. The results can be used to counsel patients and help clinicians make informed decisions about treatment. With the available number of patients, further infection-related failure was not associated with the MSIS host or limb status. Cite this article: Bone Joint J 2022;104-B(1):27–33.

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