Jacobs Michelle M J, Heesterbeek Petra J C, Veerman Karin, Goosen Jon H M
Department of Orthopaedic Surgery, Sint Maartenskliniek, Hengstdal 3, 6574NA Ubbergen, the Netherlands.
Department of Research, Sint Maartenskliniek, Hengstdal 3, 6574NA Ubbergen, the Netherlands.
J Bone Jt Infect. 2025 Jun 2;10(3):185-192. doi: 10.5194/jbji-10-185-2025. eCollection 2025.
: One-stage revisions seem to have similar reinfection rates compared to two-stage revisions for the treatment of periprosthetic joint infections based on retrospective cohort studies with a large variety of indications and treatment protocols. This study aimed to compare outcomes between comparable groups of one-stage and two-stage revision patients. : We performed a retrospective cohort study, where equal numbers of one-stage and two-stage patients (knee: ; hip: ) were randomly included with the same inclusion and exclusion criteria. Patient characteristics and infection-related outcomes at latest follow-up were obtained via chart review. Functional outcomes (knee: Knee Society Score (KSS), range of motion (ROM), and visual analogue scale (VAS) pain and satisfaction; hip: Oxford Hip Score (OHS), Hip Disability and Osteoarthritis Outcome Score-Physical Function Shortform (HOOS-PS), VAS pain and satisfaction, and European Quality of Life 5 Dimensions 3 Level version (EQ5D-3L)) preoperatively (hip only) and at 1-year follow-up were extracted from a revision database. Outcomes were compared between one- and two-stage groups and for knee and hip cases separately. : One- and two-stage groups were comparable for baseline characteristics. Reinfection occurred for both the knee and hip cohorts in one one-stage patient and one two-stage patient ( for both cohorts). More adverse events, of which two were spacer-related, were observed in two-stage hip patients ( ) compared to in one-stage patients ( ) ( ). Functional outcomes did not differ between one- and two-stage patients for both knee and hip cohorts. : This study showed no differences in terms of reinfection rates and functional outcomes between comparable groups of one- and two-stage septic knee and hip revision patients. A trend towards more adverse events in two-stage hip patients was seen, which was partly due to spacer complications.
基于大量适应症和治疗方案的回顾性队列研究，对于假体周围关节感染的治疗，一期翻修与二期翻修的再感染率似乎相似。本研究旨在比较一期和二期翻修患者可比组之间的结果。我们进行了一项回顾性队列研究，按照相同的纳入和排除标准，随机纳入数量相等的一期和二期患者（膝关节： ；髋关节： ）。通过病历审查获得最新随访时的患者特征和感染相关结果。术前（仅髋关节）和1年随访时的功能结果（膝关节：膝关节协会评分（KSS）、活动范围（ROM）以及视觉模拟量表（VAS）疼痛和满意度；髋关节：牛津髋关节评分（OHS）、髋关节残疾和骨关节炎结果评分 - 身体功能简表（HOOS - PS）、VAS疼痛和满意度以及欧洲生活质量5维度3水平版本（EQ5D - 3L））从翻修数据库中提取。对一期和二期组之间以及膝关节和髋关节病例分别进行结果比较。一期和二期组的基线特征具有可比性。在一名一期患者和一名二期患者中发生了膝关节和髋关节队列的再感染（两个队列均为 ）。与一期患者（ ）相比，二期髋关节患者（ ）观察到更多不良事件，其中两例与间隔器相关（ ）。一期和二期患者在膝关节和髋关节队列的功能结果方面没有差异。本研究表明，在可比的一期和二期感染性膝关节和髋关节翻修患者组之间，再感染率和功能结果没有差异。观察到二期髋关节患者有更多不良事件的趋势，部分原因是间隔器并发症。
