Partial component-retained two-stage reconstruction for chronic infection after uncemented total hip arthroplasty: good or bad?

Yan, Zuyun; Fang, Rui

doi:10.1007/s00264-017-3748-z

Cited by 6 publications

(10 citation statements)

References 13 publications

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“…The percentage of infection eradication ranged from 81.3% to 100% at mid-term follow-up. 12 Six main case series should be discussed in detail (Table 1).…”

Section: Clinical Resultsmentioning

confidence: 99%

“…The partial 2-stage approach yielded positive outcomes at mid-term follow-ups. [6][7][8][9][10][11][12] Based on the retention of wellfixed components, this approach reduced sequestra, bone loss, devascularization, and simplified the reimplantation stage. However, this novel approach has been highly criticized.…”

Section: Discussionmentioning

confidence: 99%

“…However, this novel approach has been highly criticized. 12,13 One main issue was probably related to patient selection and the presence of biofilm. 12,13 As all reported case series using the 2-stage approach were retrospective, the roles of biofilm and patient selection were questionable.…”

Section: Discussionmentioning

confidence: 99%

“…12,13 One main issue was probably related to patient selection and the presence of biofilm. 12,13 As all reported case series using the 2-stage approach were retrospective, the roles of biofilm and patient selection were questionable. The removal of all components was believed to be paramount in chronic PHI in order to avoid septic recurrence: in fact, most of the infections were present in the biofilm state, which was built up over a period of 36 hours to 3 weeks.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 Thus, a partial 2-stage approach was developed to treat more complex cases, retaining the well-fixed components. [6][7][8][9][10][11][12]…”

Section: Introductionmentioning

confidence: 99%

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Partial 2-Stage Revision in Chronic Hip Arthroplasty Infections: A Review

et al. 2018

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Background: Periprosthetic hip infections (PHIs) are troublesome complications of hip arthroplasties. The gold standard procedure for treating chronic PHI is a 2-stage approach. Recently, however, more conservative approaches have been developed to spare the osseointegrated components and avoid sequestra, bone loss, devascularization, and difficult reconstructions. The partial two-stage approach, which leaves the well-fixed component in situ and removes the loosened component, may be an effective strategy. Objective: This paper, a narrative mini-review, analyzed the preliminary results of a partial 2-stage approach to treating chronic hip arthroplasty infections. Methods: Pertinent papers describing the partial 2-stage approach (leaving the well-fixed component in situ and removing the loosened component) were collected and evaluated. Results: Six main case series were selected. A total of 76 patients were included. Many patients were treated with socket removal and stem retention with quite similar surgical techniques. Many cases included highly virulent bacteria, and no pre-operative selection about comorbidities was performed. The first outcomes of this approach were promising, with a rate of infection control ranging from 81.3% to 100% at mid-term follow-up. Conclusion: This approach proved good at mid-term follow-up; however, many concerns still exist. In particular, the indications are imprecise, and the role of biofilm is still unclear. Despite the first good outcomes, the partial 2-stage approach for chronic PHI should be validated by multicenter prospective studies.

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“…The percentage of infection eradication ranged from 81.3% to 100% at mid-term follow-up. 12 Six main case series should be discussed in detail (Table 1).…”

Section: Clinical Resultsmentioning

confidence: 99%