Abuelnour Moatasem, McNamee Conor, Rafi Abdul Basit, Hohlbein Wolf, Keogh Peter, Cashman James
Cappagh National Orthopaedic Hospital, Dublin, Republic of Ireland.
School of Medicine, University College Dublin, Dublin, Republic of Ireland.
J Bone Jt Infect. 2025 Feb 11;10(1):15-24. doi: 10.5194/jbji-10-15-2025. eCollection 2025.
: This study aimed to evaluate infection-free survival and outcomes after two-stage revision surgery for hip periprosthetic joint infection (PJI) performed in a specialised arthroplasty unit over 20 years. : We retrospectively identified 158 hips (154 patients) treated with two-stage revision surgery for hip PJI between 2001 and 2021. We analysed their data and presented their infection-free survival, re-operation rate, mortality, risk factors and complications. : The mean follow-up time was 9 (2 to 21.7) years. A total of 22 hips (13.9 %) were re-infected. The infection-free survival was 94.4 % at 2 years, 89.3 % at 5 years, 84.2 % at 10 years, and 82.6 % at 15 and 20 years. The re-operation rate for aseptic causes was 12 %, and the most common cause of re-operation was dislocation (7 %). The cumulative survival for re-operation for aseptic causes was 93.6 % at 2 years, 89.7 % at 5 years, 88.8 % at 10 years, and 82.8 % at 15 and 20 years. The cumulative survival for all-cause re-revision was 88.8 % at 2 years, 80.8 % at 5 years, 74.9 % at 10 years, and 68 % at 15 and 20 years. The mean Western Ontario and McMaster Universities Arthritis Index (WOMAC) hip score significantly improved from 68.3 at the pre-operative stage to 35.9 at 2.1 (2 to 3.3) years, 35.3 at 5.3 (5 to 8.4) years, 38.3 at 11.3 (10-15) years and 43.8 at 18.7 (16.5 to 21.7) years ( ). Duration of antibiotics and gram-negative infection were the only predictive risk factors for re-infection. : Our results of the two-stage revision protocol for hip PJI were satisfactory and comparable with the best reported outcomes.
本研究旨在评估在一个专业关节置换科室进行的髋关节假体周围感染（PJI）两阶段翻修手术后的无感染生存率及预后情况，研究跨度超过20年。我们回顾性确定了2001年至2021年间因髋关节PJI接受两阶段翻修手术治疗的158例髋关节（154例患者）。我们分析了他们的数据，并给出了无感染生存率、再次手术率、死亡率、风险因素及并发症情况。平均随访时间为9（2至21.7）年。共有22例髋关节（13.9%）再次感染。2年时无感染生存率为94.4%，5年时为89.3%，10年时为84.2%，15年和20年时为82.6%。无菌性原因导致的再次手术率为12%，最常见的再次手术原因是脱位（7%）。无菌性原因再次手术的累积生存率在2年时为93.6%，5年时为89.7%，10年时为88.8%，15年和20年时为82.8%。全因再次翻修的累积生存率在2年时为88.8%，5年时为80.8%，10年时为74.9%，15年和20年时为68%。平均西安大略和麦克马斯特大学骨关节炎指数（WOMAC）髋关节评分从术前的68.3显著改善至2.1（2至3.3）年时的35.9、5.3（5至8.4）年时的35.3、11.3（10至15）年时的38.3以及18.7（16.5至21.7）年时的43.8。抗生素使用时长和革兰氏阴性菌感染是再次感染的唯一预测风险因素。我们的髋关节PJI两阶段翻修方案结果令人满意，与报道的最佳结果相当。
