Two-stage hip revision arthroplasty with a hexagonal modular cementless stem in cases of periprosthetic infection

BMC Musculoskeletal Disorders

Steffen Hoell³  Jendrik Hardes³  Arne Streitbürger³  Kiriakos Daniilidis¹  Karsten Becker²  Georg Gosheger³  Dino Schulz³  Ralf Dieckmann³ 

[1] Department of Orthopedics, Hannover University Hospital, Anna-von-Borries-Strasse 1-7, 30625 Hannover, Germany;Institute of Medical Microbiology, Münster University Hospital, Albert-Schweitzer-Campus 1, A1, 48149 Münster, Germany;Department of Orthopedics and Tumor Orthopedics, Münster University Hospital, Albert-Schweitzer-Campus 1, A1, 48149 Münster, Germany

关键词: Hexagonal;    Modular;    Cementless;    Hip arthroplasty;    Periprosthetic infection;    Two-stage revision;   

Others  :  1091467
DOI  :  10.1186/1471-2474-15-398

 received in 2014-07-08, accepted in 2014-11-18,  发布年份 2014

【 摘 要 】

Background

Two-stage revision arthroplasty is today regarded as the gold standard treatment method for deep prosthetic joint infection. The aim of the present study was to evaluate clinical and functional outcomes with the Modular Universal Tumor And Revision System (MUTARS) RS stem in patients undergoing two-stage revisions.

Methods

The functional and clinical outcomes for 43 patients who had undergone two-stage revision procedures for PJI were analyzed in a retrospective study. The minimum follow-up period was 24 months. Shorter follow-up periods were only observed when there were complications such as loosening or recurrent infection. The mean follow-up period was 3.86 years (range 7 months to 11.6 years).

Results

The success rate with infection control for PJI was 93%. Reinfection occurred in four cases (7%). The risk of reinfection after MRSA infection was 20.5 times greater (P >0.01) than with sensitive or unknown bacteria. Two aseptic loosening occurred after 7 and 20 months. The average Harris Hip Score was 80 (range 62–93).

Conclusion

This retrospective study showed a 93% rate of eradication using specific antibiotic therapy. With the modular MUTARS RS stem, there was a low rate of aseptic loosening of 4.6%. MRSA infection was identified as a risk factor for reinfection. The two-stage procedure with modular cementless implants used is therefore appropriate for treating periprosthetic infections associated with hip endoprostheses.

【 授权许可】

   
2014 Dieckmann et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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