Managing early complications in total hip arthroplasty: the safety of immediate revision

Journal of Orthopaedics and Traumatology

Original Article

Victoria Teissier¹  Antoine Mouton¹  Pierre-Alban Bouché¹  Jules Descamps¹  Simon Marmor¹  Wilfrid Graff¹ 

[1] Bone-and-Joint Infections Referral Center, Groupe Hospitalier Diaconnesses Croix Saint-Simon, 125 Rue d’Avron, 75020, Paris, France;Orthopedic Surgery Departement, Groupe Hospitalier Diaconnesses Croix Saint-Simon, 125 Rue d’Avron, 75020, Paris, France;

关键词: Leg length discrepancy;    Total hip arthroplasty;    Immediate revision;    Infection;    Complication rates;   

DOI  :  10.1186/s10195-023-00719-1

 received in 2023-02-09, accepted in 2023-07-19,  发布年份 2023

来源: Springer

【 摘 要 】

PurposeImmediate revision refers to a reoperation that involves resetting, draping, and exchanging the implant, after wound closure in total hip arthroplasty. The purpose of this study is to investigate the impact of immediate revision after total hip arthroplasty on subsequent infection and complication rates.MethodsA total of 14,076 primary total hip arthroplasties performed between 2010 and 2020 were identified in our institutional database, of which 42 underwent immediate revision. Infection rates were determined 2 years after the index arthroplasty. The cause and type of revision, duration of primary and revision surgeries, National Nosocomial Infections Surveillance score, implant type, changes in implants, complications, and preoperative and intraoperative antibiotic prophylaxis were all determined.ResultsNo infections were observed within 2 years after the index arthroplasty. Leg length discrepancy (88%, n = 37) and dislocation (7.1%, n = 3) were the main causes of immediate revision. In most cases of discrepancy, the limb was clinically and radiologically longer before the immediate revision. The mean operative time was 48 ± 14 min for the primary procedure and 23.6 ± 9 min for the revision. The time between the first incision and last skin closure ranged from 1 to 3 h. None of the patients were extubated between the two procedures. Two patients had a National Nosocomial Infections Surveillance score of 2, 13 had a score of 1, and 27 had a score of 0.ConclusionImmediate revision is safe for correcting clinical and radiological abnormalities, and may not be associated with increased complication or infection rates.Study designRetrospective cohort study; level of evidence, 3.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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