title: Two-stage hip revision arthroplasty with a hexagonal modular cementless stem in cases of periprosthetic infection.
abstract: BACKGROUND
  Two-stage revision arthroplasty is today regarded as the gold standard treatment method for deep prosthetic joint infection. The aim of the present study was to evaluate clinical and functional outcomes with the Modular Universal Tumor And Revision System (MUTARS) RS stem in patients undergoing two-stage revisions.
  
  
  METHODS
  The functional and clinical outcomes for 43 patients who had undergone two-stage revision procedures for PJI were analyzed in a retrospective study. The minimum follow-up period was 24 months. Shorter follow-up periods were only observed when there were complications such as loosening or recurrent infection. The mean follow-up period was 3.86 years (range 7 months to 11.6 years).
  
  
  RESULTS
  The success rate with infection control for PJI was 93%. Reinfection occurred in four cases (7%). The risk of reinfection after MRSA infection was 20.5 times greater (P >0.01) than with sensitive or unknown bacteria. Two aseptic loosening occurred after 7 and 20 months. The average Harris Hip Score was 80 (range 62-93).
  
  
  CONCLUSIONS
  This retrospective study showed a 93% rate of eradication using specific antibiotic therapy. With the modular MUTARS RS stem, there was a low rate of aseptic loosening of 4.6%. MRSA infection was identified as a risk factor for reinfection. The two-stage procedure with modular cementless implants used is therefore appropriate for treating periprosthetic infections associated with hip endoprostheses.
authors.affiliation: Department of Orthopedics and Tumor Orthopedics, Münster University Hospital, Albert-Schweitzer-Campus 1, A1, 48149 Münster, Germany. Ralf.Dieckmann@ukmuenster.de.
authors.forename: Ralf
authors.initials: R
authors.lastname: Dieckmann
authors.forename: Dino
authors.initials: D
authors.lastname: Schulz
authors.forename: Georg
authors.initials: G
authors.lastname: Gosheger
authors.forename: Karsten
authors.initials: K
authors.lastname: Becker
authors.forename: Kiriakos
authors.initials: K
authors.lastname: Daniilidis
authors.forename: Arne
authors.initials: A
authors.lastname: Streitbürger
authors.forename: Jendrik
authors.initials: J
authors.lastname: Hardes
authors.forename: Steffen
authors.initials: S
authors.lastname: Hoell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000009:adverse effects* / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000188:drug therapy*; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents