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Patient Factors Associated With Reimplantation After Girdlestone Resection Arthroplasty for Treatment of Periprosthetic Joint Infections of the Hip. | LitMetric

AI Article Synopsis

  • Girdlestone resection arthroplasty (GRA) is an option for patients unable to have prosthesis reimplantation due to infection, and this study investigates factors influencing reimplantation using a large database from 2012-2015.
  • Out of 2,772 GRA cases, 73.1% were successfully reimplanted, with a median reimplantation time of 3 months, and factors like age, race, obesity, and comorbidities negatively impacted the likelihood of reimplantation.
  • The study highlights that male patients had higher odds for reimplantation, suggesting a need for further research into the reasons behind the variability in patient outcomes after GRA.

Article Abstract

Introduction: For patients unsuitable for prosthesis reimplantation or temporary spacer placement, Girdlestone resection arthroplasty (GRA) is a suitable option to eliminate infection. Using a large-scale database, this study aims to determine factors associated with reimplantation.

Methods: This study included patients who underwent GRA and subsequent total hip arthroplasty (2012 to 2015 Medicare Limited Data Set with ≥5-year follow-up). A mixed-effects model measured associations between patient characteristics and reimplantation. Odds ratios (OR) with 95% confidence intervals (CI) were reported.

Results: Among 2,772 GRA cases, 2,025 (73.1%) were reimplanted (median time to reimplantation 3.0 months). In multivariable analysis, patient factors associated with reduced odds of reimplantation were increased age (OR 0.96; CI, 0.94 to 0.97; P < 0.0001), Black race (OR, 0.58; CI, 0.37 to 0.90; P = 0.0149), obesity (OR, 0.74; CI, 0.58 to 0.94; P = 0.0150), and increased Deyo-Charlson comorbidities (1 comorbidity: OR, 0.78; CI, 0.61 to 0.99; P = 0.0453; two comorbidities: OR, 0.53; CI, 0.39 to 0.71; P < 0.0001; ≥3 comorbidities: OR, 0.69; CI, 0.49 to 0.95; P = 0.0244). Male (versus female) patients, however, had increased odds of reimplantation (OR, 1.64; CI, 1.32 to 2.02; P < 0.0001).

Discussion: Age, race, and comorbidities influence the likelihood of reimplantation after GRA. Owing to variability in patients who undergo additional surgery, additional studies should be conducted to determine the rationale of patient selection.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11404882PMC
http://dx.doi.org/10.5435/JAAOSGlobal-D-24-00005DOI Listing

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