Periprosthetic joint infection rates across primary total hip arthroplasty surgical approaches: a systematic review and meta-analysis of 653,633 procedures

Acuña, Alexander J.; Michael, T.; Samuel, Linsen T.; Grits, Daniel; Otero, Jesse E.; Kamath, Atul F.

doi:10.1007/s00402-021-04186-3

Cited by 9 publications

(5 citation statements)

References 70 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our experience, in line with other studies 20,21 , we found no wound or prosthetic joint infection in any patient at the last follow-up. In addition, we did not find an increased risk of dislocation or intra-operative femoral fractures in DAA patients, thus obtaining an excellent complication rate for our initial learning curve.…”

Section: Discussionsupporting

confidence: 92%

Direct anterior approach vs posterolateral approach for total hip arthroplasty: our early experience

et al. 2022

View full text Add to dashboard Cite

Objective. The direct anterior approach (DAA) for total hip arthroplasty (THA) is a surgical procedure gaining increasing popularity among hip surgeons in the last decade, even for surgeons previously accustomed to other surgical approaches. This study aimed to analyze the first cases of direct anterior approach THAs in a single institution, performed by skilled surgeons accustomed to the postero-lateral approach. Methods. We retrospectively reviewed 40 THA (38 patients) performed in our institution for primary arthritis, between December 1st 2019, and December 1st 2020. Patients were matched for age, gender, BMI and comorbidities. A matched pair analysis was performed. Results. The two groups had no statistically significant differences in hospitalization time, six-month patient-reported outcomes measures (PROMs), and radiographic measurements. However, a significant difference was observed regarding surgical timing. Conclusions. The direct anterior approach (DAA) for total hip arthroplasty is a safe and feasible technique even in the early experiences.

show abstract

Section: Discussionsupporting

confidence: 92%

Direct anterior approach vs posterolateral approach for total hip arthroplasty: our early experience

et al. 2022

View full text Add to dashboard Cite

show abstract

“…The overall reinfection rate of patients undergoing ETO for hip PJI was 8.9% significantly higher than the 1.5–2% PJI rate after primary THA [ 28 , 29 ] but comparable to the overall reinfection rate of 8.4% reported in the literature after two-stage hip revision for PJI [ 30 ]. Among the studies included in this systematic review, Morshed et al reported the highest reinfection rate (three cases, 32.1%) [ 7 ].…”

Section: Discussionmentioning

confidence: 63%

Extended trochanteric osteotomy is a safe procedure in two-stage hip revision: a systematic review of the literature

Cacciola

Giustra

Bosco

et al. 2023

Eur J Orthop Surg Traumatol

View full text Add to dashboard Cite

Background Extended trochanteric osteotomy (ETO) has proved to be an effective technique in complicated stem removal in femoral aseptic loosening or periprosthetic fracture. Debate remains about its safety in periprosthetic joint infection (PJI). The primary aim of this study is to analyze the ETO reinfection and union rate in two-stage hip revision. Material and methods A systematic literature review was performed regarding all studies reporting ETO outcomes in the two-stage revision for hip PJI up to October 2022, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. A literature search was conducted in the following databases: MEDLINE/EMBASE, Scopus, Web of Science, and Cochrane. Quality assessment of the articles was performed using the Methodological Index for Non-Randomized Studies. This systematic review was registered in the International Prospective Registry of Systematic Reviews. Patient demographic, clinical, and surgical data were collected. Results This systematic review included and analyzed nine clinical studies with a total of 382 ETO PJI hips in two-stage revision. The overall ETO reinfection rate was 8.9% (34 hips), consistent with the reinfection rate after two-stage revision in patients without ETO. The overall ETO union rate was 94.8% (347 hips), comparable to the ETO union rate in non-septic patients. Compared between a group of patients with ETO PJI and a group of patients with non-PJI ETO, there were no significant differences in postoperative complications, both septic and aseptic, and for postoperative HHS. Conclusion ETO proved to be a safe and effective procedure in PJI revisions. It may be a viable option in challenging femoral stem removal during the two-stage hip revision in PJI. Level of evidence IV.

show abstract

“…Surgical approaches might play a role in implant infection. Acuña et al ( 41 ) conducted a meta-analysis and found that patients who underwent a direct anterior approach had a significantly reduced risk of infection compared with those who underwent posterior and direct lateral approaches.…”

Section: Discussionmentioning

confidence: 99%

Total hip arthroplasty for posttraumatic osteoarthritis secondary to acetabular fracture: An evidence based on 1,284 patients from 1970 to 2018

Yuan

Wang²,

Cai³

et al. 2022

Front. Surg.

View full text Add to dashboard Cite

BackgroundPosttraumatic osteoarthritis (PTOA) can be a crippling sequela of acetabular fracture (AF), and total hip arthroplasty (THA) is often necessary to alleviate the clinical progression of symptoms. The purpose of this study was to summarize the existing clinical evidence concerning the surgical management of AF with THA through meta-analyses.MethodsDatabases were searched for articles published between 1995 and January 2022 that contained the keywords “acetabular,” “fracture,” “arthroplasty,” and “osteoarthritis.” Our study was registered in PROSPERO under number CRD42022314997.ResultsWe screened 3,125 studies and included data from 31 studies with 1,284 patients. The median patient age at the time of THA was 52 years and ranged from 19 to 94 years. The pooled overall survival rate was 88% [86%–90%, 95% confidence interval (CI)] and could reach 83% at ≥15-year follow-up. For the Harris Hip Score, we pooled 22 studies with an overall mean difference of 43.25 (40.40–46.10, 95% CI; P < 0.001), indicating a large clinical effect. The pooled complications (incidence rates) across studies were: heterotopic ossification (22.53%), implant dislocation (4.66%), implant infection (3.44%), and iatrogenic nerve injury (1.07%).ConclusionTHA in patients with PTOA following AF leads to significant improvement in symptoms and function at ≥15-year follow-up. Survival rates of implants free from re-operation or revision after THA decreased with follow-up time and could still reach 83% at ≥15-year follow-up. THA might be an effective therapeutic method for patients with PTOA due to AF.

show abstract

Periprosthetic joint infection rates across primary total hip arthroplasty surgical approaches: a systematic review and meta-analysis of 653,633 procedures

Cited by 9 publications

References 70 publications

Direct anterior approach vs posterolateral approach for total hip arthroplasty: our early experience

Direct anterior approach vs posterolateral approach for total hip arthroplasty: our early experience

Extended trochanteric osteotomy is a safe procedure in two-stage hip revision: a systematic review of the literature

Total hip arthroplasty for posttraumatic osteoarthritis secondary to acetabular fracture: An evidence based on 1,284 patients from 1970 to 2018

Contact Info

Product

Resources

About