Department of Orthopaedic Surgery, University of Southern California, Los Angeles, CA, USA.
Department of Orthopaedic Surgery, Henry Ford Health, Detroit, MI, USA.
Hip Int. 2024 Mar;34(2):194-200. doi: 10.1177/11207000231200175. Epub 2023 Sep 20.
The primary purpose of this retrospective case series was to describe the prevalence and outcomes of single-stage hip arthroplasty in patients who were previously treated for septic arthritis of the native hip at our institution over a 20-year period. This study also examined rates of persistent or recurrent infection, reoperation, and mortality for septic arthritis of the native hip.
Adult patients treated for septic arthritis of the native hip at our institution from 1995 to 2015 were retrospectively identified. Exclusion criteria included age <18 years, missing or incomplete medical records, treatment at an outside institution, and prior surgery of the hip.
97 patients were included in this study. 3 patients (3.1%) who were previously treated for septic arthritis of the native hip underwent single-stage hip arthroplasty an average of 40 ± 25 months from the date of infection. 3 of the 18 (16.7%) patients who were treated with resection arthroplasty underwent second-stage joint reconstruction. There were no cases of periprosthetic joint infection (PJI). 1 patient who underwent single-stage arthroplasty experienced implant-induced metallosis, necessitating removal of the implant. There were no other cases of revision arthroplasty.
The prevalence of single-stage hip arthroplasty in patients with a history of septic arthritis of the native hip joint was 3.1%, which is higher than the prevalence of hip arthroplasty in the United States general population, suggesting that a history of septic arthritis may increase the risk of requiring hip arthroplasty. In the small number of patients who went on to receive a hip replacement, there were no reported cases of PJI. This study suggests that hip arthroplasty is a viable option for patients with symptomatic osteoarthritis and a history of septic arthritis of their hip.
本回顾性病例系列的主要目的是描述在我们机构过去 20 年中，患有原发性髋关节感染性关节炎的患者进行一期髋关节置换术的流行率和结果。本研究还检查了原发性髋关节感染性关节炎患者持续性或复发性感染、再次手术和死亡率的发生率。
我们回顾性地确定了 1995 年至 2015 年在我们机构接受原发性髋关节感染性关节炎治疗的成年患者。排除标准包括年龄<18 岁、病历缺失或不完整、在院外治疗以及髋关节手术史。
本研究共纳入 97 例患者。3 例（3.1%）既往患有原发性髋关节感染性关节炎的患者，在感染发生后平均 40±25 个月行一期髋关节置换术。18 例接受关节切除成形术的患者中有 3 例（16.7%）行二期关节重建。无假体周围关节感染（PJI）病例。1 例接受一期关节置换术的患者发生植入物诱导的金属沉着病，需要取出植入物。无其他翻修关节置换术病例。
既往患有原发性髋关节感染性关节炎的患者行一期髋关节置换术的患病率为 3.1%，高于美国一般人群髋关节置换术的患病率，这表明感染性关节炎病史可能增加需要髋关节置换术的风险。在少数接受髋关节置换术的患者中，未报告 PJI 病例。本研究表明，对于患有症状性骨关节炎和髋关节感染性关节炎病史的患者，髋关节置换术是一种可行的选择。
