Partial two-stage exchange: an alternative method for infected total hip arthroplasty

BMC Musculoskeletal Disorders

Mumingjiang Yishake¹  Rongxin He²  Lan Tang²  Yuejian Wang²  Xi Chen³ 

[1] Department of Orthopedic Surgery, The First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang, Hangzhou, China;Department of Orthopedic Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, #88 Jiefang Road, 310009, Zhejiang, Hangzhou, China;Department of Orthopedic Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, #88 Jiefang Road, 310009, Zhejiang, Hangzhou, China;Department of Orthopedic Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, #88 Jiefang Road, 310009, Zhejiang, Hangzhou, China;Department of Public Health, Zhejiang University, Zhejiang, Hangzhou, China;

关键词: Hip;    Arthroplasty;    Periprosthetic infection;    Two-stage exchange;   

DOI  :  10.1186/s12891-021-04550-9

来源: Springer

【 摘 要 】

BackgroundTotal two-stage exchange is commonly used in clinical practice as a treatment for infected total hip arthroplasty (THA); however, this approach involves considerable limitations, including significant bone loss and severe trauma. This retrospective cohort study was conducted to evaluate clinical outcomes following the use of partial two-stage exchange (PTE) for infected THA.MethodsWe performed a retrospective analysis of 28 patients with infected THA who were treated by PTE between September 2000 and June 2019. Eligibility for PTE was limited to patients with a well-fixed femoral stem prosthesis. In the first stage of the operation, the femoral stem prosthesis was preserved; subsequently, the acetabular prosthesis, liner, and head were replaced with an antibiotic-loaded spacer. The new prosthesis was then implanted into patients and monitored for at least 3 months to ensure freedom from infection.ResultsPatients were followed for an average of 4 years (range, 2–11 years), with an overall success rate of 85.7% (24/28). The mean Harris hip score at the final follow-up was 76.2 ± 11.7 points.ConclusionsThe findings of this study suggest that PTE could be an acceptable option for a subset of patients with infected THA, offering a satisfactory infection control rate and clinical outcomes comparable to those of total two-stage exchange, but with less harm.

【 授权许可】

CC BY