title: Pre-operative scoring system to determine the surgical strategy for periprosthetic hip infection.
abstract: OBJECTIVE
  The aim of this study was to evaluate the results of one- and two-stage revision total hip arthroplasties (THAs) and to determine a rational surgical treatment strategy for periprosthetic hip infections.
  
  
  METHODS
  We constructed a 12-point preoperative scoring system to suggest either one- or two-stage revision THAs, based on a retrospective analysis of 55 operative procedures. Prosthesis survival was analysed using the Kaplan-Meier method, and the validity of the scoring system was evaluated using receiver-operating characteristic curves.
  
  
  RESULTS
  At the end point of implant removal due to recurrent infection, the ten year survival rates were 94 and 87% for one- and two-stage revision THAs, respectively. One-stage revision THA was recommended for patients scoring >9 points. The risk of recurrent infection in patients scoring 4 points was 83%. The sensitivity and specificity of a cut-off value of 4 points, determined by the scoring system, were 83 and 100%, respectively.
  
  
  CONCLUSIONS
  The novel pre-operative scoring system was useful for the management of periprosthetic hip infections.
authors.affiliation: Department of Orthopaedic Surgery, Kansai Medical University, 2-5-1 Shinmachi, Hirakata-city, Osaka, 573-1010, Japan, oeken@hirakata.kmu.ac.jp.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Oe
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Iida
authors.forename: Narumi
authors.initials: N
authors.lastname: Ueda
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Nakamura
authors.forename: Naofumi
authors.initials: N
authors.lastname: Okamoto
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ueda
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods; D005260:Female; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000601:surgery*; D012372:ROC Curve; D012086:Reoperation; D012189:Retrospective Studies; D012680:Sensitivity and Specificity