Mid-term to long-term outcome and risk factors for failure of 158 hips with two-stage revision for periprosthetic hip joint infection
<p><strong>Introduction</strong>: This study aimed to evaluate infection-free survival and outcomes after two-stage revision surgery for hip periprosthetic joint infection (PJI) performed in a specialised arthroplasty unit over 20 years. <strong>Methods</strong>: We ret...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Copernicus Publications
2025-02-01
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| Series: | Journal of Bone and Joint Infection |
| Online Access: | https://jbji.copernicus.org/articles/10/15/2025/jbji-10-15-2025.pdf |
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| Summary: | <p><strong>Introduction</strong>: This study aimed to evaluate infection-free survival and outcomes after two-stage revision surgery for hip periprosthetic joint infection (PJI) performed in a specialised arthroplasty unit over 20 years. <strong>Methods</strong>: We retrospectively identified 158 hips (154 patients) treated with two-stage revision surgery for hip PJI between 2001 and 2021. We analysed their data and presented their infection-free survival, re-operation rate, mortality, risk factors and complications. <strong>Results</strong>: The mean follow-up time was 9 (2 to 21.7) years. A total of 22 hips (13.9 %) were re-infected. The infection-free survival was 94.4 % at 2 years, 89.3 % at 5 years, 84.2 % at 10 years, and 82.6 % at 15 and 20 years. The re-operation rate for aseptic causes was 12 %, and the most common cause of re-operation was dislocation (7 %). The cumulative survival for re-operation for aseptic causes was 93.6 % at 2 years, 89.7 % at 5 years, 88.8 % at 10 years, and 82.8 % at 15 and 20 years. The cumulative survival for all-cause re-revision was 88.8 % at 2 years, 80.8 % at 5 years, 74.9 % at 10 years, and 68 % at 15 and 20 years. The mean Western Ontario and McMaster Universities Arthritis Index (WOMAC) hip score significantly improved from 68.3 at the pre-operative stage to 35.9 at 2.1 (2 to 3.3) years, 35.3 at 5.3 (5 to 8.4) years, 38.3 at 11.3 (10–15) years and 43.8 at 18.7 (16.5 to 21.7) years (<span class="inline-formula"><i>p</i><0.01</span>). Duration of antibiotics and gram-negative infection were the only predictive risk factors for re-infection. <strong>Conclusion</strong>: Our results of the two-stage revision protocol for hip PJI were satisfactory and comparable with the best reported outcomes.</p> |
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| ISSN: | 2206-3552 |