Two-stage revision surgery with preformed spacers and cementless implants for septic hip arthritis : a prospective, non-randomized cohort study
Articolo
Data di Pubblicazione:
2011
Citazione:
Two-stage revision surgery with preformed spacers and cementless implants for
septic hip arthritis : a prospective, non-randomized cohort study / C.L. Romanò, D. Romanò, E. Meani, N. Logoluso, L. Drago. - In: BMC INFECTIOUS DISEASES. - ISSN 1471-2334. - 11(2011 May 16), pp. 129.129.1-129.129.7.
Abstract:
BACKGROUND: Outcome data on two-stage revision surgery for deep
infection after septic hip arthritis are limited and inconsistent. This study
presents the medium-term results of a new, standardized two-stage arthroplasty
with preformed hip spacers and cementless implants in a consecutive series of
adult patients with septic arthritis of the hip treated according to a same
protocol.
METHODS: Nineteen patients (20 hips) were enrolled in this prospective,
non-randomized cohort study between 2000 and 2008. The first stage comprised
femoral head resection, debridement, and insertion of a preformed, commercially
available, antibiotic-loaded cement hip spacer. After eradication of infection, a
cementless total hip arthroplasty was implanted in the second stage. Patients
were assessed for infection recurrence, pain (visual analog scale [VAS]) and hip
joint function (Harris Hip score).
RESULTS: The mean time between first diagnosis of infection and revision surgery
was 5.8 ± 9.0 months; the average duration of follow up was 56.6 (range, 24 -
104) months; all 20 hips were successfully converted to prosthesis an average 22
± 5.1 weeks after spacer implantation. Reinfection after total hip joint
replacement occurred in 1 patient. The mean VAS pain score improved from 48
(range, 35 - 84) pre-operatively to 18 (range, 0 - 38) prior to spacer removal
and to 8 (range, 0 - 15) at the last follow-up assessment after prosthesis
implantation. The average Harris Hip score improved from 27.5 before surgery to
61.8 between the two stages to 92.3 at the final follow-up assessment.
CONCLUSIONS: Satisfactory outcomes can be obtained with two-stage revision hip
arthroplasty using preformed spacers and cementless implants for prosthetic hip
joint infections of various etiologies.
Tipologia IRIS:
01 - Articolo su periodico
Elenco autori:
C.L. Romanò, D. Romanò, E. Meani, N. Logoluso, L. Drago
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