Outcomes of hip arthroplasty with concomitant hardware removal: influence of the type of implant retrieved and impact of positive intraoperative cultures

Madariaga, Salvador de; Vargas-Reverón, Caribay; Tornero, Eduard; Alias, Alfonso Jesús; Capurro, Bruno; Combalía, A.; Fernández-Valencia, Jenaro Á.; Muñoz-Mahamud, Ernesto

doi:10.1007/s00402-020-03692-0

Cited by 4 publications

(10 citation statements)

References 26 publications

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“…On the other hand, the conversion THAs reported a higher rate of complications, a consistently longer operative time and a greater likelihood of receiving a blood transfusion. In contrast to other authors [ 2 ], no deaths were recorded.…”

Section: Discussioncontrasting

confidence: 97%

“…As mentioned before, a higher incidence of blood transfusion and overall peri-operative complications were reported (13.8% versus 2.4%); this result has to be related to a more difficult surgical procedure. Madariaga et al [ 2 ] found even more cases that required a new surgery (23.6%).…”

Section: Discussionmentioning

confidence: 99%

“…In our opinion, non-union is a highly suspicious condition for underlying infection that has to be extensively investigated and, due to this, is probably not suitable for a one-stage conversion. In previous studies, Madariaga et al [ 2 ] found five cases of early PJI out of 55 patients (9.1%), and Scholten et al [ 5 ] found a higher incidence in a single-stage group of early PJI compared to the two-stage group (8.6% versus 3.8%, p = 0.234). In both studies, a higher number of non-union cases were reported in the one-stage group.…”

Section: Discussionmentioning

confidence: 99%

“…Given the lack of guidelines, no preoperative hip aspiration was performed. The hardware removal group came only from a selected cohort with no elevated CRP or any sign or history of infection [ 9 ] and a satisfactory bone healing; moreover, Madariaga et al [ 2 ] performed a CT-guided aspiration in only seven cases on 55 and was negative in all cases, finding that no PJI were developed following microorganism isolation after THA conversion.…”

Section: Discussionmentioning

confidence: 99%

“…Single-stage hardware removal and total hip arthroplasty (THA) is a viable surgical procedure following failed surgical treatment of a proximal femoral fracture, post-trauma end-stage osteoarthritis (OA) or following preserving surgery of the hip [ 1 ]. Conversion THA (cTHA) procedures have increased overtime because of the population aging associated with an increasing number of patients treated for hip fractures and the development of newer and safer hip-preserving surgical techniques [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

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Clinical Outcomes and Complication Rate after Single-Stage Hardware Removal and Total Hip Arthroplasty: A Matched-Pair Controlled Study

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Matteo

Maio

et al. 2023

JCM

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Background: Single-stage hardware removal and total hip arthroplasty is a complex surgical procedure, comparable to revision surgery. The purpose of the current study is to evaluate single-stage hardware removal and THA outcomes, compare this technique with a matched control group that has undergone primary THA and assess the risk of periprosthetic joint infection with a 24-month minimum follow-up. Methods: This study included all those cases treated with THA and concomitant hardware removal from 2008 to 2018. The control group was selected on a 1:1 ratio among patients who underwent THA for primary OA. The Harris Hip (HHS) and University of California at Los Angeles Activity (UCLA) scores, infection rate and early and delayed surgical complications were recorded. Results: One hundred and twenty-three consecutive patients (127 hips) were included, and the same number of patients was assigned to the control group. The final functional scores were comparable between the two groups; a longer operative time and transfusion rate were recorded in the study group. Finally, an increased incidence of overall complications was reported (13.8% versus 2.4%), but no cases of early or delayed infection were found. Conclusions: Single-stage hardware removal and THA is a safe and effective but technically demanding technique, with a higher incidence of overall complications, making it more similar to revision THA than to primary THA.

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Section: Discussioncontrasting

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical Outcomes and Complication Rate after Single-Stage Hardware Removal and Total Hip Arthroplasty: A Matched-Pair Controlled Study

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Matteo

Maio

et al. 2023

JCM

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Dynamic hip screw in proximal femoral fractures followed by “single-stage” hip arthroplasty—retrospective analysis

Hrubina,

Necas,

Sammoudi

et al. 2023

Eur J Orthop Surg Traumatol

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The aim of this study is to present the results of single-stage total hip arthroplasty (THA) after Dynamic Hip Screw (DHS) failure, or secondary posttraumatic osteoarthrosis. From 2003 to 2020, 15 THAs were performed in group of 15 patients for the treatment of DHS failure, or for late complications following femoral neck and pertrochanteric fractures. The mean follow-up period after arthroplasty was 46.9 months (range 7–139). The patients were evaluated retrospectively—both clinically and radiographically, focussing on the demography, infection rate and other complications (revision surgery), during the year 2023. 9 males and 6 females were included in the study, with a mean age of 56.5 years (range 29–93) at the time of primary osteosynthesis. Each of them had proximal femoral fracture treated primarily with a DHS and then late one-stage revision surgery, with hardware removal and THA implantation. The median time between DHS osteosynthesis and THA was 41.2 months (range 4–114). Four patients (26.6%) had complications after THA, with the need for revision in two cases (13.3%). Dislocation rate was 6.6% (one case), with the need for repeated-revision of THA. The infection rate was 6.6% (one patient) with the need for revision of THA. Peroperative periprosthetic femoral fracture was observed in 13.3% (two patients) without any other problems. Six patients (40%) died during the follow-up period. Single-stage total hip arthroplasty with concomitant hardware removal bears a high- mortality rate, with a higher incidence of postoperative complications compared to elective THA.

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How to identify the patient at risk of hip periprosthetic joint infections

2022

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Outcomes of hip arthroplasty with concomitant hardware removal: influence of the type of implant retrieved and impact of positive intraoperative cultures

Cited by 4 publications

References 26 publications

Clinical Outcomes and Complication Rate after Single-Stage Hardware Removal and Total Hip Arthroplasty: A Matched-Pair Controlled Study

Clinical Outcomes and Complication Rate after Single-Stage Hardware Removal and Total Hip Arthroplasty: A Matched-Pair Controlled Study

Dynamic hip screw in proximal femoral fractures followed by “single-stage” hip arthroplasty—retrospective analysis

How to identify the patient at risk of hip periprosthetic joint infections

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