La Camera Francesco, de Matteo Vincenzo, Di Maio Marco, Verrazzo Raffaele, Grappiolo Guido, Loppini Mattia
IRCCS Humanitas Research Hospital, Via Alessandro Manzoni 56, 20089 Rozzano, Italy.
Fondazione Livio Sciutto Ricerca Biomedica in Ortopedia-ONLUS, Via A. Magliotto 2, 17100 Savona, Italy.
J Clin Med. 2023 Feb 19;12(4):1666. doi: 10.3390/jcm12041666.
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.
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.
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.
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.
一期取出内固定物并进行全髋关节置换术是一种复杂的外科手术，堪比翻修手术。本研究的目的是评估一期取出内固定物及全髋关节置换术的疗效，将该技术与接受初次全髋关节置换术的匹配对照组进行比较，并在至少24个月的随访期内评估假体周围关节感染的风险。
本研究纳入了2008年至2018年期间接受全髋关节置换术并同时取出内固定物的所有病例。对照组在接受初次全髋关节置换术治疗原发性骨关节炎的患者中按1:1比例选取。记录Harris髋关节（HHS）评分和加州大学洛杉矶分校活动（UCLA）评分、感染率以及早期和延迟手术并发症。
连续纳入123例患者（127髋），并为对照组分配了相同数量的患者。两组最终的功能评分相当；研究组的手术时间更长，输血率更高。最后，报告的总体并发症发生率有所增加（13.8%对2.4%），但未发现早期或延迟感染病例。
一期取出内固定物并进行全髋关节置换术是一种安全有效的技术，但技术要求较高，总体并发症发生率较高，使其更类似于全髋关节翻修术而非初次全髋关节置换术。
