Simon Sebastian, Frank Bernhard J H, Gardete Susana, Aichmair Alexander, Mitterer Jennyfer Angel, Dominkus Martin, Hofstaetter Jochen G
Michael-Ogon Laboratory for Orthopaedic Research, Orthopaedic Hospital Vienna-Speising, 1130 Vienna, Austria.
II. Department of Orthopaedic Surgery, Orthopaedic Hospital Vienna-Speising, 1130 Vienaa, Austria.
J Clin Med. 2021 Nov 5;10(21):5180. doi: 10.3390/jcm10215180.
Resection arthroplasty can be performed as the first stage of a two-stage procedure in some patients with severe periprosthetic hip joint infections with poor bone stock. This retrospective study aimed to evaluate factors associated with the subsequent failure or success of these patients. Between 2011 and 2020; in 61 (26.4%) of 231 patients who underwent a two-stage protocol of periprosthetic hip joint infections; no spacer was used in the first stage. The minimum follow-up period was 12 months. Patient's demographics and various infection risk factors were analyzed. In total, 37/61 (60.7%) patients underwent a successful reimplantation, and four patients died within the follow-up period. Patients within the failure group had a significantly higher Charlson comorbidity index ( = 0.002); number of operations prior to resection arthroplasty ( = 0.022) and were older ( = 0.018). Failure was also associated with the presence of a positive culture in the first- and second-stage procedures ( = 0.012). Additional risk factors were persistent high postoperative CRP values and the requirement of a negative-pressure wound therapy ( ≤ 0.05). In conclusion, multiple factors need to be evaluated when trying to predict the outcome of patients undergoing resection arthroplasty as the first stage of a two-stage procedure in patients with challenging periprosthetic hip joint infections.
对于一些假体周围髋关节感染严重且骨量较差的患者，切除关节成形术可作为两阶段手术的第一阶段进行。这项回顾性研究旨在评估与这些患者随后的失败或成功相关的因素。在2011年至2020年期间；在231例行假体周围髋关节感染两阶段治疗方案的患者中，有61例（26.4%）在第一阶段未使用间隔物。最短随访期为12个月。分析了患者的人口统计学特征和各种感染风险因素。总共，61例患者中有37例（60.7%）成功进行了再植入，4例患者在随访期内死亡。失败组患者的Charlson合并症指数显著更高（ = 0.002）；切除关节成形术前的手术次数（ = 0.022）且年龄更大（ = 0.018）。失败还与第一阶段和第二阶段手术中培养结果为阳性有关（ = 0.012）。其他风险因素包括术后CRP值持续居高以及需要进行负压伤口治疗（ ≤ 0.05）。总之，在试图预测接受切除关节成形术作为具有挑战性的假体周围髋关节感染患者两阶段手术第一阶段的患者预后时，需要评估多个因素。
