Analysis of Failed Two-Stage Procedures with Resection Arthroplasty as the First Stage in Periprosthetic Hip Joint Infections

Resection arthroplasty can be performed as the first stage of a two-stage procedure in some patients with severe periprosthetic hip joint infections with poor bone stock. This retrospective study aimed to evaluate factors associated with the subsequent failure or success of these patients. Between 2...

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Autores principales:	Sebastian Simon, Bernhard J.H. Frank, Susana Gardete, Alexander Aichmair, Jennyfer Angel Mitterer, Martin Dominkus, Jochen G. Hofstaetter
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	resection arthroplasty two-stage procedure risk-factors PJI Medicine R
Acceso en línea:	https://doaj.org/article/06a1a11cd6b6484ca4cb6ee5e88a865c
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spelling	oai:doaj.org-article:06a1a11cd6b6484ca4cb6ee5e88a865c2021-11-11T17:47:25ZAnalysis of Failed Two-Stage Procedures with Resection Arthroplasty as the First Stage in Periprosthetic Hip Joint Infections10.3390/jcm102151802077-0383https://doaj.org/article/06a1a11cd6b6484ca4cb6ee5e88a865c2021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/5180https://doaj.org/toc/2077-0383Resection arthroplasty can be performed as the first stage of a two-stage procedure in some patients with severe periprosthetic hip joint infections with poor bone stock. This retrospective study aimed to evaluate factors associated with the subsequent failure or success of these patients. Between 2011 and 2020; in 61 (26.4%) of 231 patients who underwent a two-stage protocol of periprosthetic hip joint infections; no spacer was used in the first stage. The minimum follow-up period was 12 months. Patient’s demographics and various infection risk factors were analyzed. In total, 37/61 (60.7%) patients underwent a successful reimplantation, and four patients died within the follow-up period. Patients within the failure group had a significantly higher Charlson comorbidity index (<i>p</i> = 0.002); number of operations prior to resection arthroplasty (<i>p</i> = 0.022) and were older (<i>p</i> = 0.018). Failure was also associated with the presence of a positive culture in the first- and second-stage procedures (<i>p</i> = 0.012). Additional risk factors were persistent high postoperative CRP values and the requirement of a negative-pressure wound therapy (<i>p</i> ≤ 0.05). In conclusion, multiple factors need to be evaluated when trying to predict the outcome of patients undergoing resection arthroplasty as the first stage of a two-stage procedure in patients with challenging periprosthetic hip joint infections.Sebastian SimonBernhard J.H. FrankSusana GardeteAlexander AichmairJennyfer Angel MittererMartin DominkusJochen G. HofstaetterMDPI AGarticleresection arthroplastytwo-stage procedurerisk-factorsPJIMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5180, p 5180 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	resection arthroplasty two-stage procedure risk-factors PJI Medicine R
spellingShingle	resection arthroplasty two-stage procedure risk-factors PJI Medicine R Sebastian Simon Bernhard J.H. Frank Susana Gardete Alexander Aichmair Jennyfer Angel Mitterer Martin Dominkus Jochen G. Hofstaetter Analysis of Failed Two-Stage Procedures with Resection Arthroplasty as the First Stage in Periprosthetic Hip Joint Infections
description	Resection arthroplasty can be performed as the first stage of a two-stage procedure in some patients with severe periprosthetic hip joint infections with poor bone stock. This retrospective study aimed to evaluate factors associated with the subsequent failure or success of these patients. Between 2011 and 2020; in 61 (26.4%) of 231 patients who underwent a two-stage protocol of periprosthetic hip joint infections; no spacer was used in the first stage. The minimum follow-up period was 12 months. Patient’s demographics and various infection risk factors were analyzed. In total, 37/61 (60.7%) patients underwent a successful reimplantation, and four patients died within the follow-up period. Patients within the failure group had a significantly higher Charlson comorbidity index (<i>p</i> = 0.002); number of operations prior to resection arthroplasty (<i>p</i> = 0.022) and were older (<i>p</i> = 0.018). Failure was also associated with the presence of a positive culture in the first- and second-stage procedures (<i>p</i> = 0.012). Additional risk factors were persistent high postoperative CRP values and the requirement of a negative-pressure wound therapy (<i>p</i> ≤ 0.05). In conclusion, multiple factors need to be evaluated when trying to predict the outcome of patients undergoing resection arthroplasty as the first stage of a two-stage procedure in patients with challenging periprosthetic hip joint infections.
format	article
author	Sebastian Simon Bernhard J.H. Frank Susana Gardete Alexander Aichmair Jennyfer Angel Mitterer Martin Dominkus Jochen G. Hofstaetter
author_facet	Sebastian Simon Bernhard J.H. Frank Susana Gardete Alexander Aichmair Jennyfer Angel Mitterer Martin Dominkus Jochen G. Hofstaetter
author_sort	Sebastian Simon
title	Analysis of Failed Two-Stage Procedures with Resection Arthroplasty as the First Stage in Periprosthetic Hip Joint Infections
title_short	Analysis of Failed Two-Stage Procedures with Resection Arthroplasty as the First Stage in Periprosthetic Hip Joint Infections
title_full	Analysis of Failed Two-Stage Procedures with Resection Arthroplasty as the First Stage in Periprosthetic Hip Joint Infections
title_fullStr	Analysis of Failed Two-Stage Procedures with Resection Arthroplasty as the First Stage in Periprosthetic Hip Joint Infections
title_full_unstemmed	Analysis of Failed Two-Stage Procedures with Resection Arthroplasty as the First Stage in Periprosthetic Hip Joint Infections
title_sort	analysis of failed two-stage procedures with resection arthroplasty as the first stage in periprosthetic hip joint infections
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/06a1a11cd6b6484ca4cb6ee5e88a865c
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Analysis of Failed Two-Stage Procedures with Resection Arthroplasty as the First Stage in Periprosthetic Hip Joint Infections

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