Repeat 2-stage exchange for infected total hip arthroplasty: a viable option?
We investigated whether performing a repeat 2-stage exchange eradicates infection in patients who previously underwent 2-stage treatment for an infected total hip arthroplasty. We identified 15 patients who had failed a 2-stage total hip arthroplasty and underwent a planned repeat 2-stage between 2000 and 2009. Of the 15 patients, 8 were treated with a complete 2-stage procedure, whereas the remaining 7 patients were treated only with a first-stage resection of the infected implant. Of the 8 patients who underwent complete 2-stage exchange, 1 died because of in-hospital complications, and 1 had a recurrent infection. Repeat infection is highly associated with resistant organisms, obesity, and poor patient health. Of the 7 patients who underwent resection without reimplantation, 3 had a recurrent infection. Our data suggest that if infection can be adequately controlled after repeat resection of the joint prosthesis, reimplantation is a reasonable option.
The Rothman Institute of Orthopaedics at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
S M Javad
SM
Mortazavi
Joseph T
JT
O'Neil
Benjamin
B
Zmistowski
Javad
J
Parvizi
James J
JJ
Purtill
D040981:Acinetobacter baumannii / Q000302:isolation & purification; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D019468:Disease Management; D013293:Enterococcus faecalis / Q000302:isolation & purification; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000382:microbiology* / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000453:epidemiology* / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013211:Staphylococcus aureus / Q000302:isolation & purification; D016896:Treatment Outcome