[Early results of one-stage septic revision arthroplasties with antibiotic-laden cement. A clinical and statistical analysis].
BACKGROUND
Periprosthetic infections will generally require revision arthroplasty. The one-stage revision arthroplasty with antibiotic-laden cement is hence an attractive therapeutic option, since it only requires one operation, has a low morbidity and, if successful, is cost-efficient.


METHODS
We performed one-stage revision arthroplasties. The exchanged prostheses were fixed with antibiotic-laden cement after biotic resistance was determined. All patients were treated with postoperative systemic antibiotics.


RESULTS
After a mean postoperative examination period of 18.4 months, we confirmed eradication of infection in 14 of 15 knee joints and in 15 of 16 hip joints. The mean duration of hospital stay was 23 days. Patients' satisfaction was high (93.55%) and the clinical results were satisfactory.


CONCLUSIONS
Our analysis shows that our low early reinfection rate (6.45%) is within statistical expectation. Furthermore, we have showed that there is evidence to suggest that the rate of successful outcomes in one-stage revision arthroplasties, at least at the hip, is not different from the rate of two-stage revision arthroplasties and that the difference may be interpreted as stochastic deviation (p=0.264494). According to existing studies, an analogy to knee arthroplasties can be assumed. We demonstrated that one-stage revision is an adequate therapeutic option if patients are carefully selected and under the supervision of an experienced surgeon.
Sofer
D
D
Chirurgische Klinik II, Unfall- und Wiederherstellungschirurgie, Klinikum Darmstadt, Darmstadt. dsofer@gmx.de
Regenbrecht
B
B
Pfeil
J
J
D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019644:Arthroplasty, Replacement, Hip / Q000379:methods / Q000706:statistics & numerical data*; D019645:Arthroplasty, Replacement, Knee / Q000379:methods / Q000706:statistics & numerical data*; D001843:Bone Cements / Q000627:therapeutic use*; D003692:Delayed-Action Preparations / Q000008:administration & dosage; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D010865:Pilot Projects; D016459:Prosthesis-Related Infections / Q000453:epidemiology* / Q000601:surgery*; D020127:Recovery of Function; D012086:Reoperation / Q000379:methods / Q000706:statistics & numerical data; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D001843:Bone Cements; D003692:Delayed-Action Preparations