Infection is a devastating complication of total hip arthroplasty (THA). This study aimed to determine whether 2-stage reimplantation is still effective for treating contemporary pathogens, including multidrug-resistant organisms. Records of all cases of infected THAs from 1989 to 2003 were reviewed for data on organism, presence of drug resistance, use of an antibiotic-impregnated spacer, type of reimplant, and success of treatment. Of the 87 protocol patients with 2 years of follow-up, 94.3% (82) underwent reimplantation. The original infection was eradicated in 80 of the 84 hips (78/82 patients), a success rate of 95%. All 21 multidrug-resistant infections were eradicated. There were no major differences in eradication rates when the period was split into 3 sections. These results support previous studies from our institution which demonstrated the effectiveness of a 2-stage reimplantation protocol with a standard 1:8 minimal bactericidal titer for treating infections after THA, including those due to methicillin-resistant organisms.
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http://dx.doi.org/10.1016/j.arth.2008.07.004 | DOI Listing |
Orthop Traumatol Surg Res
October 2024
Department of Orthopaedic Surgery, Hospital La Croix-Saint Simon, 125, Rue d'Avron, 75020, Paris, France.
Purpose: This prospective clinical cohort was undertaken to determine the long-term risks of reinfection and all-cause aseptic failure after 1-stage exchange total knee arthroplasties (TKA) in a large series of consecutive patients with periprosthetic joint infection (PJI) following TKA.
Hypothesis: One-stage exchange for chronic PJI is an effective strategy, even in a non-selected population.
Patients And Methods: Non-selected patients (152 with 154 PJI) undergoing 1-stage-exchange TKA for PJI (January 2003-August 2015) were prospectively included and monitored for ≥2 years.
Arch Orthop Trauma Surg
December 2024
Department of Orthopaedic Surgery, Santa Maria Annunziata Hospital, Azienda USL Toscana Centro, Bagno A Ripoli, FI, Italy.
J Arthroplasty
September 2024
National Yang Ming Chiao Tung University, Institute of Statistics, Hsinchu, Taiwan.
Background: The clinical challenge of unexpected positive intraoperative cultures (UPICs) persists in 2-stage resection arthroplasty for managing periprosthetic joint infections (PJIs) following total knee arthroplasty.(TKA). This study aimed to investigate the incidence of UPICs during the definitive reimplantation phase of 2-stage resection arthroplasty of the knee and to assess both the infection-free and revision-free survivorship of the implanted prosthesis.
View Article and Find Full Text PDFJ Shoulder Elbow Surg
July 2024
Levy Shoulder to Hand Center at the Paley Orthopedic and Spine Institute, Boca Raton, FL, USA. Electronic address:
Background: Periprosthetic infections remain a challenging complication after shoulder arthroplasty, and an ideal treatment protocol has yet to be established. Two-stage revision is a common approach. Historically, the first stage entails placement of an all-cement antibiotic spacer.
View Article and Find Full Text PDFArthroplast Today
June 2024
Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Background: Semipermanent functional spacers are now utilized for prosthetic joint infection in an attempt to avoid another surgery with 2-stage treatment. This study evaluates the results of metal-on-polyethylene articulating spacers for the treatment of chronic native septic knee arthritis.
Methods: This is a retrospective review of 18 patients treated with metal-on-polyethylene articulating antibiotic spacers constructed with all-polyethylene tibial components or with polyethylene inserts (PIs) with Steinmann pins or screws for chronic native knee infection.
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