Restoration of the hip geometry after two-stage exchange with intermediate resection arthroplasty for periprosthetic joint infection

Abstract Two-stage exchange with intermediate resection arthroplasty (RA) is a well-established surgical procedure in the treatment of chronic periprosthetic joint infection (PJI), whereby a higher failure rate of final hip geometry restoration due to tissue contraction is controversially discussed....

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Autores principales:	Jan Hubert, Frank Timo Beil, Tim Rolvien, Christian Ries, Stephan Frosch, Dominik Saul, Thelonius Hawellek
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/274222716f684f8a9e4e4ed3e4a46033
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spelling	oai:doaj.org-article:274222716f684f8a9e4e4ed3e4a460332021-12-02T13:19:22ZRestoration of the hip geometry after two-stage exchange with intermediate resection arthroplasty for periprosthetic joint infection10.1038/s41598-021-84692-x2045-2322https://doaj.org/article/274222716f684f8a9e4e4ed3e4a460332021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-84692-xhttps://doaj.org/toc/2045-2322Abstract Two-stage exchange with intermediate resection arthroplasty (RA) is a well-established surgical procedure in the treatment of chronic periprosthetic joint infection (PJI), whereby a higher failure rate of final hip geometry restoration due to tissue contraction is controversially discussed. The aim was to evaluate radiographic changes of hip geometry parameters during PJI treatment and to determine the impact of the intermediate RA on the final joint restoration after reimplantation of a total hip arthroplasty (reTHA). Radiographic parameters (leg length (LL), femoral offset (FO), horizontal/vertical acetabular center of rotation distance (h/vCORD)) of 47 patients (mean age: 64.1 years) were measured on standard radiographs of the pelvis and compared between four different stages during PJI treatment (pre-replacement status (preTHA), primary total hip arthroplasty (pTHA), RA and reTHA). The RA duration (mean: 10.9 months) and the number of reoperations during this period (mean: n = 2.0) as well as their impact on hip geometry restoration were evaluated. Between preTHA and pTHA/reTHA an equivalent restoration was measured regarding the FO (p < 0.001/p < 0.001) and hCORD (p = 0.016/p < 0.001), but not regarding the LL and vCORD. In contrast, analysis revealed no influence of RA and an equivalent reconstruction of LL (p = 0.003), FO (p < 0.001), v/hCORD (p = 0.039/p = 0.035) at reTHA compared to pTHA. Furthermore, RA duration (p = 0.053) and the number of reoperations after RA (p = 0.134) had no impact on radiographic hip geometry restoration. The two-stage exchange with intermediate RA does not alter the preexisting hip joint parameters, whereby a good restoration of the final hip geometry, independent of the duration or the number of reoperations, can be achieved.Jan HubertFrank Timo BeilTim RolvienChristian RiesStephan FroschDominik SaulThelonius HawellekNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jan Hubert Frank Timo Beil Tim Rolvien Christian Ries Stephan Frosch Dominik Saul Thelonius Hawellek Restoration of the hip geometry after two-stage exchange with intermediate resection arthroplasty for periprosthetic joint infection
description	Abstract Two-stage exchange with intermediate resection arthroplasty (RA) is a well-established surgical procedure in the treatment of chronic periprosthetic joint infection (PJI), whereby a higher failure rate of final hip geometry restoration due to tissue contraction is controversially discussed. The aim was to evaluate radiographic changes of hip geometry parameters during PJI treatment and to determine the impact of the intermediate RA on the final joint restoration after reimplantation of a total hip arthroplasty (reTHA). Radiographic parameters (leg length (LL), femoral offset (FO), horizontal/vertical acetabular center of rotation distance (h/vCORD)) of 47 patients (mean age: 64.1 years) were measured on standard radiographs of the pelvis and compared between four different stages during PJI treatment (pre-replacement status (preTHA), primary total hip arthroplasty (pTHA), RA and reTHA). The RA duration (mean: 10.9 months) and the number of reoperations during this period (mean: n = 2.0) as well as their impact on hip geometry restoration were evaluated. Between preTHA and pTHA/reTHA an equivalent restoration was measured regarding the FO (p < 0.001/p < 0.001) and hCORD (p = 0.016/p < 0.001), but not regarding the LL and vCORD. In contrast, analysis revealed no influence of RA and an equivalent reconstruction of LL (p = 0.003), FO (p < 0.001), v/hCORD (p = 0.039/p = 0.035) at reTHA compared to pTHA. Furthermore, RA duration (p = 0.053) and the number of reoperations after RA (p = 0.134) had no impact on radiographic hip geometry restoration. The two-stage exchange with intermediate RA does not alter the preexisting hip joint parameters, whereby a good restoration of the final hip geometry, independent of the duration or the number of reoperations, can be achieved.
format	article
author	Jan Hubert Frank Timo Beil Tim Rolvien Christian Ries Stephan Frosch Dominik Saul Thelonius Hawellek
author_facet	Jan Hubert Frank Timo Beil Tim Rolvien Christian Ries Stephan Frosch Dominik Saul Thelonius Hawellek
author_sort	Jan Hubert
title	Restoration of the hip geometry after two-stage exchange with intermediate resection arthroplasty for periprosthetic joint infection
title_short	Restoration of the hip geometry after two-stage exchange with intermediate resection arthroplasty for periprosthetic joint infection
title_full	Restoration of the hip geometry after two-stage exchange with intermediate resection arthroplasty for periprosthetic joint infection
title_fullStr	Restoration of the hip geometry after two-stage exchange with intermediate resection arthroplasty for periprosthetic joint infection
title_full_unstemmed	Restoration of the hip geometry after two-stage exchange with intermediate resection arthroplasty for periprosthetic joint infection
title_sort	restoration of the hip geometry after two-stage exchange with intermediate resection arthroplasty for periprosthetic joint infection
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/274222716f684f8a9e4e4ed3e4a46033
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Restoration of the hip geometry after two-stage exchange with intermediate resection arthroplasty for periprosthetic joint infection

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