title: Two-Stage Revision Arthroplasty for Periprosthetic Hip Infection: Mean Follow-Up of Ten Years.
abstract: BACKGROUND
  Two-stage revision hip arthroplasty is the gold standard for treatment of patients with chronic periprosthetic joint infection (PJI), but few studies have reported outcomes beyond short-term follow-up.
  
  
  METHODS
  A total of 155 patients who underwent two-stage revision arthroplasty for chronic PJI in 157 hips were retrospectively enrolled in this study between January 2001 and December 2010. The mean patient age was 57.5 years, the mean prosthetic age was 3.6 years, and the interim interval was 17.8 weeks. These patients were followed up for an average of 9.7 years.
  
  
  RESULTS
  At the latest follow-up, 91.7% of the patients were free of infection. The mean Harris hip score improved significantly from 28.3 points before operation to 85.7 points at the latest follow-up. Radiographically, there was aseptic loosening of the stem or acetabular components in 4 patients. In the multivariate survival analysis using a Cox regression model, repeated debridement before final reconstruction, an inadequate interim period, bacteriuria or pyuria, and cirrhosis were found to be the independent risk factors for treatment failure.
  
  
  CONCLUSIONS
  Our data show that two-stage revision hip arthroplasty provides reliable eradication of infection and durable reconstruction of the joint in patients with PJI caused by a variety of pathogens.
authors.affiliation: Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 5 Fu-Hsing Street, Kweishan, Taoyuan 333, Taiwan.
authors.forename: Szu-Yuan
authors.identifier: 0000-0002-7564-8202
authors.initials: SY
authors.lastname: Chen
authors.affiliation: Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 5 Fu-Hsing Street, Kweishan, Taoyuan 333, Taiwan.
authors.forename: Chi-Chien
authors.initials: CC
authors.lastname: Hu
authors.affiliation: Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 5 Fu-Hsing Street, Kweishan, Taoyuan 333, Taiwan.
authors.forename: Chun-Chieh
authors.initials: CC
authors.lastname: Chen
authors.affiliation: Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 5 Fu-Hsing Street, Kweishan, Taoyuan 333, Taiwan.
authors.forename: Yu-Han
authors.initials: YH
authors.lastname: Chang
authors.affiliation: Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 5 Fu-Hsing Street, Kweishan, Taoyuan 333, Taiwan.
authors.forename: Pang-Hsin
authors.initials: PH
authors.lastname: Hsieh
mesh_terms: D000077:Acetabulum / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001170:Arthritis, Infectious / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D001863:Bone Screws / Q000382:microbiology; D005260:Female; D006621:Hip Joint / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D019736:Prostheses and Implants / Q000009:adverse effects* / Q000382:microbiology; D011475:Prosthesis Failure / Q000009:adverse effects; D016896:Treatment Outcome