Persistent Chronic Periprosthetic Joint Infection Treated with Three-Stage Revision Hip Arthroplasty: A Case Report
Background: Periprosthetic Joint Infection (PJI) is a dreadful complication of primary Total Hip Arthroplasty (THA). Following revision THA, up to 17% of revision THA can be complicated with PJI. Three-stage revision should only be done if simple debridement fails to treat PJI. Here we present a rar...
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Universitas Airlangga
2023-04-01
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| Series: | Journal Orthopaedi and Traumatology Surabaya |
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| Online Access: | https://e-journal.unair.ac.id/JOINTS/article/view/43675 |
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| author | Nurul Ramadian Jifaldi Afrian Maharaja Dinda Sedar |
| author_facet | Nurul Ramadian Jifaldi Afrian Maharaja Dinda Sedar |
| author_sort | Nurul Ramadian |
| collection | DOAJ |
| description | Background: Periprosthetic Joint Infection (PJI) is a dreadful complication of primary Total Hip Arthroplasty (THA). Following revision THA, up to 17% of revision THA can be complicated with PJI. Three-stage revision should only be done if simple debridement fails to treat PJI. Here we present a rare case of persistent PJI, treated with three-stage revision and bone grafting.
Case Report: A thirty-seven-year-old female patient came with a chief complaint of hip pain four months ago. Four years ago, the patient had a right column femur fracture and was treated with THA. One year afterward, the implant was infected, and the hip was debrided. One year later, the infection symptom recurred, and three-stage revision hip arthroplasty was planned with one year delay for each stage: removal of the implant, replacement of spacer, and reimplantation. The acetabular bone was augmented using autograft from the iliac wing during reimplantation. After reimplantation, the pain subsides, and the patient can walk normally again.
Discussion: Previous studies have found various risk factors that might contribute to the failure of two-stage revision arthroplasty. The infecting bacteria is one of the major risk factors, and therefore appropriate antibiotic is important. Augmentation of bone graft can also supplement acetabular bone loss during failed THA as it helps as a scaffold for bone healing.
Conclusion: Three-stage revision hip arthroplasty after PJI using bone graft for augmentation is possible with a good result. |
| format | Article |
| id | doaj-art-ea6eaf92f08f49c298da742e8b325efe |
| institution | Kabale University |
| issn | 2722-712X 2460-8742 |
| language | English |
| publishDate | 2023-04-01 |
| publisher | Universitas Airlangga |
| record_format | Article |
| series | Journal Orthopaedi and Traumatology Surabaya |
| spelling | doaj-art-ea6eaf92f08f49c298da742e8b325efe2025-02-12T07:28:05ZengUniversitas AirlanggaJournal Orthopaedi and Traumatology Surabaya2722-712X2460-87422023-04-01121313510.20473/joints.v12i1.2023.31-3541757Persistent Chronic Periprosthetic Joint Infection Treated with Three-Stage Revision Hip Arthroplasty: A Case ReportNurul Ramadian0https://orcid.org/0009-0006-5538-8809Jifaldi Afrian Maharaja Dinda Sedar1https://orcid.org/0009-0008-7843-5545Department of Orthopedics and Traumatology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, IndonesiaDepartment of Orthopedics and Traumatology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, IndonesiaBackground: Periprosthetic Joint Infection (PJI) is a dreadful complication of primary Total Hip Arthroplasty (THA). Following revision THA, up to 17% of revision THA can be complicated with PJI. Three-stage revision should only be done if simple debridement fails to treat PJI. Here we present a rare case of persistent PJI, treated with three-stage revision and bone grafting. Case Report: A thirty-seven-year-old female patient came with a chief complaint of hip pain four months ago. Four years ago, the patient had a right column femur fracture and was treated with THA. One year afterward, the implant was infected, and the hip was debrided. One year later, the infection symptom recurred, and three-stage revision hip arthroplasty was planned with one year delay for each stage: removal of the implant, replacement of spacer, and reimplantation. The acetabular bone was augmented using autograft from the iliac wing during reimplantation. After reimplantation, the pain subsides, and the patient can walk normally again. Discussion: Previous studies have found various risk factors that might contribute to the failure of two-stage revision arthroplasty. The infecting bacteria is one of the major risk factors, and therefore appropriate antibiotic is important. Augmentation of bone graft can also supplement acetabular bone loss during failed THA as it helps as a scaffold for bone healing. Conclusion: Three-stage revision hip arthroplasty after PJI using bone graft for augmentation is possible with a good result.https://e-journal.unair.ac.id/JOINTS/article/view/43675total hip arthroplastyperiprosthetic joint infectionspacerdebridementhuman and medicine |
| spellingShingle | Nurul Ramadian Jifaldi Afrian Maharaja Dinda Sedar Persistent Chronic Periprosthetic Joint Infection Treated with Three-Stage Revision Hip Arthroplasty: A Case Report Journal Orthopaedi and Traumatology Surabaya total hip arthroplasty periprosthetic joint infection spacer debridement human and medicine |
| title | Persistent Chronic Periprosthetic Joint Infection Treated with Three-Stage Revision Hip Arthroplasty: A Case Report |
| title_full | Persistent Chronic Periprosthetic Joint Infection Treated with Three-Stage Revision Hip Arthroplasty: A Case Report |
| title_fullStr | Persistent Chronic Periprosthetic Joint Infection Treated with Three-Stage Revision Hip Arthroplasty: A Case Report |
| title_full_unstemmed | Persistent Chronic Periprosthetic Joint Infection Treated with Three-Stage Revision Hip Arthroplasty: A Case Report |
| title_short | Persistent Chronic Periprosthetic Joint Infection Treated with Three-Stage Revision Hip Arthroplasty: A Case Report |
| title_sort | persistent chronic periprosthetic joint infection treated with three stage revision hip arthroplasty a case report |
| topic | total hip arthroplasty periprosthetic joint infection spacer debridement human and medicine |
| url | https://e-journal.unair.ac.id/JOINTS/article/view/43675 |
| work_keys_str_mv | AT nurulramadian persistentchronicperiprostheticjointinfectiontreatedwiththreestagerevisionhiparthroplastyacasereport AT jifaldiafrianmaharajadindasedar persistentchronicperiprostheticjointinfectiontreatedwiththreestagerevisionhiparthroplastyacasereport |