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Time to Reimplantation: Waiting Longer Confers No Added Benefit
- Source :
- The Journal of arthroplasty. 33(6)
- Publication Year :
- 2017
-
Abstract
- While the preferred surgical treatment for chronic periprosthetic joint infection (PJI) in North America is a 2-stage exchange arthroplasty, the optimal time between first-stage and reimplantation surgery remains unknown. This study was conceived to examine the association between time to reimplantation and treatment failure.Using an institutional database, we identified PJI cases treated with 2-stage exchange arthroplasty between 2000 and 2016. Musculoskeletal Infection Society criteria were used to define PJI, and treatment failure was defined using Delphi criteria. The interstage interval between first-stage and reimplantation surgery for each case was collected, alongside demographics, patient-related and organism-specific data. Multivariate logistic regression analyses were used to examine association with treatment failure.Our final analysis consisted of 282 patients with an average time to reimplantation of 100.2 days (range, 20-648). Sixty-three patients (22.3%) failed at 1 year based on Delphi criteria. Time to reimplantation was not significantly associated with failure in both univariate (P = .598) and multivariate (P = .397) models. However, patients reimplanted at26 weeks were twice as likely to fail in comparison to those reimplanted within26 weeks (43.8% vs 21.1%), and this finding reached marginal significance (P = .057). Patients who failed had significantly more comorbidities (P = .008). Charlson comorbidity index was the only variable significantly associated with treatment failure in regression analysis (odds ratio, 1.40; 95% confidence interval, 1.06-1.86; P = .019).The length of the interstage interval was not a statistically significant predictor of failure in patients undergoing 2-stage exchange arthroplasty for PJI.
- Subjects :
- Male
Reoperation
medicine.medical_specialty
Prosthesis-Related Infections
Time Factors
Databases, Factual
medicine.medical_treatment
Arthroplasty, Replacement, Hip
Periprosthetic
Logistic regression
Musculoskeletal infection
Treatment failure
03 medical and health sciences
0302 clinical medicine
Odds Ratio
Medicine
Humans
Orthopedics and Sports Medicine
In patient
030212 general & internal medicine
Treatment Failure
Arthroplasty, Replacement, Knee
Aged
Retrospective Studies
030222 orthopedics
Arthritis, Infectious
business.industry
Univariate
Middle Aged
Time optimal
Arthroplasty
Surgery
North America
Female
business
Subjects
Details
- ISSN :
- 15328406
- Volume :
- 33
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- The Journal of arthroplasty
- Accession number :
- edsair.doi.dedup.....1b894a4430a4bcc2f640b495e2819c26