Shu Henry T, Ghanem Diane, Covarrubias Oscar, Elsabbagh Zaid, Hughes Alice J, Sotsky Rachel B, Conway Janet D, Ferguson Jamie, Osgood Greg M, Shafiq Babar
Department of Orthopaedic Surgery, Johns Hopkins Hospital, Baltimore, MD 21287, USA.
Department of Orthopaedic Surgery, Johns Hopkins Bayview Medical Center, Baltimore, MD 21224, USA.
Antibiotics (Basel). 2024 Aug 21;13(8):782. doi: 10.3390/antibiotics13080782.
This retrospective cohort study aims to investigate the clinical outcomes of Girdlestone resection arthroplasty (GRA) in injection drug users with septic hip arthritis. Patients who underwent primary GRA for septic hip arthritis secondary to injection drug use at two academic trauma centers from 2015 to 2023 were retrospectively reviewed. Patient demographics, surgical details, and follow-up outcomes, including patient-reported outcome measures, were collected and analyzed. The cohort included 15 patients, with a mean age of 44 ± 11 years and a mean follow-up period of 25 ± 20 months. Among the 15 patients, overall mortality was 27%, and only 4 patients underwent total hip arthroplasty (THA) following GRA. Infection resolution rates were significantly higher in patients who received an antibiotic spacer (75% vs. 0%, = 0.048). GRA in injection drug users is associated with high mortality and low conversion rates to THA. The use of an antibiotic spacer during GRA significantly improves infection resolution rates. Larger studies are required to determine the optimal management strategies for this patient population.
这项回顾性队列研究旨在调查注射吸毒所致化脓性髋关节炎患者行Girdlestone切除关节成形术（GRA）的临床结局。对2015年至2023年在两个学术创伤中心因注射吸毒继发化脓性髋关节炎而接受初次GRA的患者进行回顾性分析。收集并分析患者的人口统计学资料、手术细节以及随访结局，包括患者报告的结局指标。该队列包括15例患者，平均年龄44±11岁，平均随访时间25±20个月。15例患者中，总死亡率为27%，GRA术后仅4例患者接受了全髋关节置换术（THA）。接受抗生素间隔物治疗的患者感染清除率显著更高（75%对0%，P = 0.048）。注射吸毒患者行GRA与高死亡率和低THA转化率相关。GRA期间使用抗生素间隔物可显著提高感染清除率。需要开展更大规模的研究以确定该患者群体的最佳管理策略。
