1. Cementless One-Stage Revision in Chronic Periprosthetic Hip Joint Infection. Ninety-One Percent Infection Free Survival in 56 Patients at Minimum 2-Year Follow-Up
- Author
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Jeppe Lange, Anders Troelsen, Søren Solgaard, Kristian S. Otte, Niels K. Jensen, Kjeld Søballe, Andre Zawadski, Anne Grete Kjersgaard, Christian Heine, Jess Riis, Kristian Stahl Otte, Martin Lamm, Mohammad Hossein Dehghani, Niels Krarup, Ninna Rysholdt Poulsen, Per Kjærsgaard-Andersen, Poul Torben Nielsen, Søren Søndergaard Mikkelsen, Thomas Prynø, Thomas Vester, and Thue Ørsnes
- Subjects
Adult ,Reoperation ,medicine.medical_specialty ,Prosthesis-Related Infections ,medicine.medical_treatment ,assessment ,Arthroplasty, Replacement, Hip ,Periprosthetic ,Oxford hip score ,Hip Joint/microbiology ,surgery ,03 medical and health sciences ,0302 clinical medicine ,Clinical Protocols ,Hip replacement ,medicine ,Journal Article ,Hip Prosthesis/adverse effects ,Humans ,Orthopedics and Sports Medicine ,Cumulative incidence ,030212 general & internal medicine ,Cementation ,Survival analysis ,Aged ,030222 orthopedics ,business.industry ,Incidence (epidemiology) ,Bone Cements ,Prosthesis-Related Infections/drug therapy ,Middle Aged ,Arthroplasty ,Confidence interval ,infection ,Surgery ,Prosthesis Failure ,Arthroplasty, Replacement, Hip/adverse effects ,Chronic Disease ,arthroplasty ,Female ,Hip Joint ,Hip Prosthesis ,business ,Follow-Up Studies - Abstract
Background: Cementless 1-stage revision in chronic periprosthetic hip joint infections is limited evaluated. The purpose of this study was to evaluate a specific treatment protocol in this patient group.Methods: The study was performed as a multicenter, proof-of-concept, observational study with prospective data collection. Patients were treated with a cementless 1-stage revision according to the CORIHA protocol between 2009 and 2014. Fifty-six patients, McPherson type III-A/B-1/2, were enrolled with a mean follow-up time from the CORIHA procedure of 4 years (minimum of 2 years). The primary outcome was re-revision performed due to infection and was evaluated by competing risk analysis, with death and aseptic revision as competing events. All-cause mortality was evaluated by Kaplan-Meier survival analysis. Oxford Hip Score (OHS) was used as disease-specific patient-reported outcome measure.Results: The cumulative incidence of re-revision due to infection was 8.9% (confidence interval [CI] 3.2%-18.1%). The 1-year and 5-year survival incidence was 96% (CI 86%-99%) and 89% (CI 75%-95%). OHS at baseline was 19.9 (CI 17.3-22.6) and at 24-month follow-up 35.1 (CI 31.7-38.5). The mean change in OHS from baseline to 24-month follow-up was 11.8 points (CI 7.3; 16.3). Three patients had aseptic revision performed: two suffered periprosthetic fractures and one had stem subsidence. Failure analysis of the 5 reinfections did not detect a clear pattern as to the cause of failure.Conclusion: We found that cementless 1-stage revision in chronic periprosthetic hip joint infections has low reinfection rates in selected patients and may be applicable as a first-line treatment. (c) 2017 Elsevier Inc. All rights reserved.
- Published
- 2017
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