Infection and failure rates following total hip arthroplasty for septic arthritis: a case-controlled study

Papanna, Madhavan C.; Chebbout, R.; Buckley, S; Stockley, I; Hamer, A. J.

doi:10.5301/hipint.5000538

Cited by 36 publications

(49 citation statements)

References 22 publications

(48 reference statements)

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“…The results are the same as in previous studies [25]. In addition, the proportion of heterotopic ossification was 4.95% (5 hips), which was also lower than that reported in previous studies [4, 26], and the proportion of heterotopic ossification in these studies was 28.5% (2 out of 7 hips) and 9.4% (16 out of 170 hips), respectively.…”

Section: Discussionsupporting

confidence: 85%

Clinical outcomes and quality of life after total hip arthroplasty in adult patients with a history of infection of the hip in childhood: a mid-term follow-up study

et al. 2019

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BackgroundTotal hip arthroplasty for adult patients with a history of infection of the hip in childhood could be a more technically demanding procedure due to complicated anatomy and the possibility of reinfection. Here, we conducted a mid-term analysis of clinical outcomes in such patients after primary cementless total hip arthroplasty (THA).MethodsWe reviewed 101 patients (101 hips; 51 men; mean age, 52.3 years) who underwent cementless THA between 2008 and 2015, at a mean of 24 years (range, 11–43) since the resolution of childhood hip infection. Patients were followed up for a mean of 6.1 years (range, 2.1–9.6). Clinical outcomes and quality of life after THA were assessed at final follow-up.ResultsNo cases of infection were reported during the follow-up, and patients showed significant improvement in Harris Hip Score, for which the mean score increased from 48.5 to 90 points; the modified Merle d’Aubigne and Postel (MAP) Hip Score; the Hip Dysfunction and Osteoarthritis Outcome Score; the SF-12; and mean limb length discrepancy, which decreased from 3.4 to 1.1 cm. During follow-up, four cases of prosthesis dislocation, three of transient sciatic paralysis, seven of femoral fracture, five of heterotopic ossification, and 19 of osteolysis were recorded. Revision surgery was performed for two patients, one for isolated loosening of the acetabular component and another for loosening of the femoral stem.ConclusionCementless THA can effectively treat patients with a quiescent period of infection of the hip of more than 10 years, resulting in good functional outcomes and fewer complications. Risk of infection recurrence after THA in these patients seems extremely low.

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Section: Discussionsupporting

confidence: 85%

Clinical outcomes and quality of life after total hip arthroplasty in adult patients with a history of infection of the hip in childhood: a mid-term follow-up study

et al. 2019

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“…Recently, the two-stage procedure to a TJA may be considered as a worthy alternative in the management of SA [2, 4, 5]. Papanna et al [2] reported on 18 cases with SA who underwent one-stage or two-stage TJA based on whether the infection was active or quiescent. There was no reinfection or implant failure in this cohort at a mean follow-up of 70 months.…”

Section: Discussionmentioning

confidence: 99%

“…The evolutive septic arthritis (SA) of the hip and knee in adults is a rare but dramatically disastrous disease. Evolutive SA is known to potentially cause devastating cartilage and bone damage as well as poor joint function overall [1, 2]. Recently, the incidence of SA is increasing owing to the aging population and more invasive joint procedures performed [3].…”

Section: Introductionmentioning

confidence: 99%

Outcomes and predictors of treatment failure following two-stage total joint arthroplasty with articulating spacers for evolutive septic arthritis

Xu¹,

Kuo

Kheir

et al. 2019

BMC Musculoskelet Disord

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Background The treatment strategy for evolutive septic arthritis (SA) with coexistent degenerative joint disease is not well established. The purposes of this study were to 1) investigate treatment outcome and potential risk factors of treatment failure in patients with evolutive SA following two-stage procedure, including insertion of an antibiotic-loaded spacer at the first stage and subsequent implantation of a new prosthesis; and 2) determine the performance of serum erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and Interleukin-6 (IL-6) in predicting persisting infection at second-stage procedure. Methods We retrospectively reviewed 74 patients with evolutive SA of hips and knees who underwent a two-stage TJA between 2008 and 2015. The treatment success was defined according to the modified Delphi criteria and Kaplan-Meier survivorship curves were constructed to determine treatment success. A Cox regression model was performed to identify risk factors for treatment failure. Receiver operating characteristic (ROC) curves were generated to determine the prognostic value of ESR, CRP, and IL-6 in predicting persistent infection before second-stage prostheses implantation. Results Overall, the treatment success rate was 93% for hips and 100% for knees after the first-stage surgery. The treatment success rate was 89% for hips and 84% for knees after second-stage prosthesis implantation with a mean follow-up of 4.7 (range, 2.2 to 10.8) years. Older age (Hazard ratio [HR] [per 10-year increase], 1.20; 95% confidential interval [CI], 1.11 to 1.62), higher preoperative CRP level (HR [per 1-mg/dL increase], 1.15; 95% CI, 1.04 to 1.28) and resistant organism (HR, 13.96; 95% CI, 3.29 to 19.20) were associated with an increased risk of treatment failure. All serologic tests presented limited values in predicting persisting infection, with the area under ROC curve of ESR, CRP, IL-6 and combination of the three markers was 57.8, 61.6, 60.3, and 62.1%, respectively. Conclusions Two-stage TJA is an adequate management of infection control in patients with evolutive SA. The three potential risk factors (old age, high preoperative CRP, and resistant organism profile) may predict treatment failure following a two-stage procedure for evolutive SA. Additionally, serum ESR, CRP, and IL-6 had no benefit in predicting persisting infection before second-stage prostheses implantation. These findings may be useful when treating patients with evolutive SA.

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“…We are aware of only three studies that have explored this topic. One small study [12] compared reinfection and occurrence of PJI in 18 patients who had hip native septic arthritis and were treated with THA using single-(n = 11 patients) and two-stage approaches (n = seven patients) compared with a control cohort of 18 patients who underwent routine primary THA with mean followup of 70 months. They reported no infections in either cohort.…”

Section: Discussionmentioning

confidence: 99%

“…However, a clear link between a history of a resolved native joint septic arthritis as a direct risk factor for PJI when primary TJA is performed in the same joint has not clearly been established. Previous studies have suggested contradictory evidence and have had results that varied between reporting substantially higher PJI rates [14] to very low or no reported PJI rates [2,4,12]. However, most of these studies mainly aimed at reporting on the outcomes of TJA as a treatment option for patients with persistent or quiescent native joint septic arthritis versus investigating previous native joint septic arthritis as an independent risk factor for developing PJI.…”

Section: Introductionmentioning

confidence: 99%

Patients with a History of Treated Septic Arthritis are at High Risk of Periprosthetic Joint Infection after Total Joint Arthroplasty

Sultan

Mahmood

Samuel

et al. 2019

Clin Orthop Relat Res

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Background In patients undergoing total joint arthroplasty (TJA), increasing attention has been directed recently toward identifying specific patient-related risk factors that may predispose patients to periprosthetic joint infection (PJI). Currently, it is unclear whether having a history of a treated native septic arthritis is a risk factor for PJI after TJA in the same joint. Previous studies have reported contradictory evidence and results varied between a substantially higher rates of PJIs to very low or no reported PJIs. Questions/purposes (1) What is the risk of PJI in patients who received TJA and had a history of treated same-joint native joint septic arthritis and (2) What are the associated risk factors for these patients developing PJI? Methods This was a multicenter retrospective analysis of patients who received primary THA or TKA between January 2000 and December 2016 and who had a history of treated native joint septic arthritis in the same joint. Patients were included in the study only if they were considered to have resolved their joint infection based on a preoperative evaluation that included: (1) the absence of clinical symptoms and signs of active infection or local joint inflammation, (2) recent plain radiographs showing only

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Infection and failure rates following total hip arthroplasty for septic arthritis: a case-controlled study

Abstract: Two-stage and single-stage THA for active and quiescent native hip infection respectively, achieved similar outcomes to THA for primary osteoarthritis in controls.

Cited by 36 publications

References 22 publications

Clinical outcomes and quality of life after total hip arthroplasty in adult patients with a history of infection of the hip in childhood: a mid-term follow-up study

Clinical outcomes and quality of life after total hip arthroplasty in adult patients with a history of infection of the hip in childhood: a mid-term follow-up study

Outcomes and predictors of treatment failure following two-stage total joint arthroplasty with articulating spacers for evolutive septic arthritis

Patients with a History of Treated Septic Arthritis are at High Risk of Periprosthetic Joint Infection after Total Joint Arthroplasty

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