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Early prosthetic joint infections treated with debridement and implant retention: 38 primary hip arthroplasties prospectively recorded and followed for median 4 years.

Westberg M, Grøgaard B, Snorrason F - Acta Orthop (2012)

Bottom Line: However, previous studies have found inconsistent results, with success rates ranging from 21% to 100%, and little has been written in the literature about hip function.Median Harris hip score was 86 (47-100) points.In 9 of the 11 patients for whom treatment failed, infection was successfully treated with 1-stage or 2-stage reimplantation or resection.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Oslo University Hospital, Oslo, Norway. marianne.westberg@oslo-universitetssykehus.no

ABSTRACT

Background and purpose: Debridement and retention of the prosthesis is often attempted to treat early prosthetic joint infection (PJI). However, previous studies have found inconsistent results, with success rates ranging from 21% to 100%, and little has been written in the literature about hip function. We have therefore analyzed the clinical and functional outcome of early PJIs treated with this procedure.

Patients and methods: 38 patients with early PJI after primary hip arthroplasty who were treated with debridement and retention of the implant between 1998 and 2005 were studied prospectively, with a median follow-up time of 4 (0.8-10) years. Early infection was defined as that which occurred within 4 weeks of index arthroplasty. The primary outcome measure was infection control. Functional outcome was assessed with the Harris hip score.

Results: 27 of 38 patients were successfully treated, with no signs of infection or continued antibiotic treatment at the latest follow-up. Median Harris hip score was 86 (47-100) points. In 9 of the 11 patients for whom treatment failed, infection was successfully treated with 1-stage or 2-stage reimplantation or resection. Intraoperative cultures were positive in 36 hips, and the most frequently isolated organisms were Staphylococcus aureus and coagulase-negative staphylococci (CoNS). 15 infections were polymicrobial, and only 8 of them were successfully treated with debridement and retention of the implant.

Interpretation: Our data suggest that debridement and retention of the prosthesis is a reasonable treatment option in early PJI after primary hip arthroplasty, with satisfactory functional results.

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Related in: MedlinePlus

Flow chart of 38 hips with early PJI treated with debridement and implant retention
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Figure 1: Flow chart of 38 hips with early PJI treated with debridement and implant retention

Mentions: Fisher’s exact test was used to compare categorical variables. A p-value of < 0.05 was considered significant.


Early prosthetic joint infections treated with debridement and implant retention: 38 primary hip arthroplasties prospectively recorded and followed for median 4 years.

Westberg M, Grøgaard B, Snorrason F - Acta Orthop (2012)

Flow chart of 38 hips with early PJI treated with debridement and implant retention
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3369146&req=5

Figure 1: Flow chart of 38 hips with early PJI treated with debridement and implant retention
Mentions: Fisher’s exact test was used to compare categorical variables. A p-value of < 0.05 was considered significant.

Bottom Line: However, previous studies have found inconsistent results, with success rates ranging from 21% to 100%, and little has been written in the literature about hip function.Median Harris hip score was 86 (47-100) points.In 9 of the 11 patients for whom treatment failed, infection was successfully treated with 1-stage or 2-stage reimplantation or resection.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Oslo University Hospital, Oslo, Norway. marianne.westberg@oslo-universitetssykehus.no

ABSTRACT

Background and purpose: Debridement and retention of the prosthesis is often attempted to treat early prosthetic joint infection (PJI). However, previous studies have found inconsistent results, with success rates ranging from 21% to 100%, and little has been written in the literature about hip function. We have therefore analyzed the clinical and functional outcome of early PJIs treated with this procedure.

Patients and methods: 38 patients with early PJI after primary hip arthroplasty who were treated with debridement and retention of the implant between 1998 and 2005 were studied prospectively, with a median follow-up time of 4 (0.8-10) years. Early infection was defined as that which occurred within 4 weeks of index arthroplasty. The primary outcome measure was infection control. Functional outcome was assessed with the Harris hip score.

Results: 27 of 38 patients were successfully treated, with no signs of infection or continued antibiotic treatment at the latest follow-up. Median Harris hip score was 86 (47-100) points. In 9 of the 11 patients for whom treatment failed, infection was successfully treated with 1-stage or 2-stage reimplantation or resection. Intraoperative cultures were positive in 36 hips, and the most frequently isolated organisms were Staphylococcus aureus and coagulase-negative staphylococci (CoNS). 15 infections were polymicrobial, and only 8 of them were successfully treated with debridement and retention of the implant.

Interpretation: Our data suggest that debridement and retention of the prosthesis is a reasonable treatment option in early PJI after primary hip arthroplasty, with satisfactory functional results.

Show MeSH
Related in: MedlinePlus