Two-Stage Revision Protocol in Multidrug Resistant Periprosthetic Infection Following Total Hip Arthroplasty Using a Long Interval Between Stages

J Arthroplasty. 2015 Sep;30(9):1602-6. doi: 10.1016/j.arth.2015.04.004. Epub 2015 Apr 17.

Abstract

We retrospectively reviewed the medical records of 31 patients with periprosthetic hip infections attempting to evaluate the outcome of a two-stage revision protocol characterized by prolonged interim period (mean=9.2 months, range 8-12 months) prior to the final re-implantation. In 3 cases (9.6%) the 1st stage was repeated after a mean period of 12.3 weeks due to relapse of infection. Five spacer dislocations occurred, not affecting the final clinical outcome after reimplantation, as evaluated by the Harris Hip Score. No protrusions or additional acetabular bone loss was noticed. Our proposed protocol is a simple, safe, efficient and reproducible treatment approach that may be successfully utilized predominantly when dealing with multidrug resistant pathogens.

Keywords: cement; complications; hip; infection; long interval; periprosthetic.

MeSH terms

  • Acetabulum / surgery
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Arthroplasty, Replacement, Hip / methods
  • Chronic Disease
  • Drug Resistance, Multiple, Bacterial
  • Female
  • Gram-Positive Bacterial Infections / drug therapy
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Prosthesis-Related Infections / surgery*
  • Recurrence
  • Reoperation / methods*
  • Retrospective Studies
  • Teicoplanin / therapeutic use
  • Time Factors

Substances

  • Anti-Bacterial Agents
  • Teicoplanin