Lim Jbt, Pang H N, Tay Kjd, Chia S L, Yeo S J, Lo N N
Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
Malays Orthop J. 2020 Nov;14(3):73-81. doi: 10.5704/MOJ.2011.012.
This study aims to investigate whether patients undergoing two-stage revision total hip arthroplasty (THA) for prosthetic joint infection (PJI) and one-stage revision THA for aseptic reasons have similar clinical outcomes and patient satisfaction during their post-operative follow-up. We hypothesise that the two-stage revision THA for PJI is associated with poorer outcomes as compared to aseptic revision THA.
We reviewed prospectively collected data in our tertiary hospital arthroplasty registry and identified patients who underwent revision THA between 2001 and 2014, with a minimum of two years follow-up. The study group (two-stage revision THA for PJI) consists of 23 patients and the control group (one-stage revision THA for aseptic reasons) consists of 231 patients. Patient demographics, Western Ontario and McMaster Universities Arthritis Index (WOMAC), Oxford Hip Score (OHS), Short Form-36 (SF-36) scores and patient reported satisfaction were evaluated. Student's t-test was used to compare continuous variables between the two groups. Statistical significance was defined as p <0.05.
The pre-operative demographics and clinical scores were relatively similar between the two groups of patients. At two years, patients who underwent revision THA for PJI reported a better WOMAC Pain Score and OHS as compared to aseptic revision THA. A similar proportion of patients were satisfied with their results of surgery in both groups (p=0.093).
Although patients who underwent revision THA for PJI had poorer pre-operative functional scores (WOMAC function and SF-36 PF), at two years follow-up, these two groups of patients have comparable post-operative outcomes. Interestingly, patients who had revision THA for PJI reported a better clinical outcome in terms of OHS and WOMAC Pain score as compared to the aseptic group. We conclude that the revision THA for PJI is not inferior to aseptic revision THA in terms of patient satisfaction and clinical outcomes.
本研究旨在调查因假体关节感染（PJI）接受两阶段翻修全髋关节置换术（THA）的患者与因无菌性原因接受一阶段翻修THA的患者在术后随访期间是否具有相似的临床结果和患者满意度。我们假设与无菌性翻修THA相比，因PJI进行的两阶段翻修THA的结果较差。
我们回顾了在我们三级医院关节置换登记处前瞻性收集的数据，并确定了2001年至2014年间接受翻修THA且至少随访两年的患者。研究组（因PJI进行两阶段翻修THA）由23名患者组成，对照组（因无菌性原因进行一阶段翻修THA）由231名患者组成。评估了患者的人口统计学数据、西安大略和麦克马斯特大学关节炎指数（WOMAC）、牛津髋关节评分（OHS）、简短健康调查问卷36项（SF - 36）评分以及患者报告的满意度。采用学生t检验比较两组之间的连续变量。统计学显著性定义为p<0.05。
两组患者术前的人口统计学数据和临床评分相对相似。在两年时，因PJI接受翻修THA的患者与无菌性翻修THA相比，报告的WOMAC疼痛评分和OHS更好。两组中对手术结果满意的患者比例相似（p = 0.093）。
尽管因PJI接受翻修THA的患者术前功能评分（WOMAC功能和SF - 36身体功能）较差，但在两年随访时，这两组患者的术后结果相当。有趣的是，与无菌组相比，因PJI接受翻修THA的患者在OHS和WOMAC疼痛评分方面报告的临床结果更好。我们得出结论，就患者满意度和临床结果而言，因PJI进行的翻修THA并不劣于无菌性翻修THA。
