title: Outcomes of revision total hip replacement for infection after grading according to a standard protocol.
abstract: Periprosthetic infection following total hip replacement can be a catastrophic complication for the patient. The treatments available include single-stage exchange, and two-stage exchange. We present a series of 50 consecutive patients with a diagnosis of infected total hip replacement who were assessed according to a standardised protocol. Of these, 11 underwent single-stage revision arthroplasty with no recurrence of infection at a mean of 6.8 years follow-up (5.5 to 8.8). The remaining 39 underwent two-stage revision, with two recurrences of infection successfully treated by a second two-stage procedure. At five years, significant differences were found in the mean Harris Hip Scores (single-stage 87.8; two-stage 75.5; p = 0.0003) and in a visual analogue score for satisfaction (8.6; 6.9; p = 0.001) between the single- and two-stage groups. Single-stage exchange is successful in eradicating periprosthetic infection and results in excellent functional and satisfaction scores. Identification of patients suitable for the single-stage procedure allows individualisation of care and provides as many as possible with the correct strategy in successfully tackling their periprosthetic infection.
authors.affiliation: Chelsea and Westminster Hospital, 369 Fulham Road, London, UK. sam_ous@hotmail.com
authors.forename: S I S
authors.initials: SI
authors.lastname: Oussedik
authors.forename: M B
authors.initials: MB
authors.lastname: Dodd
authors.forename: F S
authors.initials: FS
authors.lastname: Haddad
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000175:diagnosis* / Q000628:therapy*; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000628:therapy*; D012092:Replantation
chemical_list: D000900:Anti-Bacterial Agents