dc.contributor.author
Hipfl, Christian
dc.contributor.author
Karczewski, Daniel
dc.contributor.author
Oronowicz, Jakub
dc.contributor.author
Pumberger, Matthias
dc.contributor.author
Perka, Carsten
dc.contributor.author
Hardt, Sebastian
dc.date.accessioned
2023-07-12T11:47:18Z
dc.date.available
2023-07-12T11:47:18Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/40060
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-39782
dc.description.abstract
Introduction: The optimal treatment of patients with a degenerative joint disease secondary to an active or chronic septic arthritis of the hip is unclear. The aim of the present study was to report on our experience with two-stage total hip arthroplasty (THA) using a contemporary treatment protocol without spacer insertion.
Materials and methods: Our prospective institutional database was used to identify all patients with degenerative septic arthritis treated with a non-spacer two-stage protocol between 2011 and 2017. Clinical outcomes included interim revision, periprosthetic infection (PJI) and aseptic revision rates. Restoration of leg-length and offset were assessed radiographically. Modified Harris hip score (mHHS) were obtained. Treatment success was defined using the modified Delphi consensus criteria. Mean follow-up was 62 months (13-110).
Results: A total of 33 patients with a mean age of 60 years (13-85) were included. 55% of the cohort was male and average Charlson Comorbidity Index (CCI) was 3.7 (0-12). 21 patients (64%) had an active/acute infection and 12 patients (36%) were treated for chronic/quiescent septic arthritis. Overall, 11 patients (33%) had treatment failure, including 5 patients who failed to undergo THA, 2 interim re-debridement for persistent infection, and 4 patients who developed PJI after an average of 7 months (0.3-13) following THA. The most common identified pathogen was Staphylococcus aureus (42.4%). No aseptic revision was recorded following THA. Leg-length and offset were successfully restored. Mean mHHS improved from 35.2 points to 73.4 points.
Conclusion: Two-stage THA without spacer placement is a viable treatment option for destructive septic arthritis of the hip, demonstrating comparable rates of infection control and functional outcome. However, definitive resection arthroplasty is not uncommon in these often critically ill patients.
en
dc.rights.uri
https://creativecommons.org/licenses/by/4.0/
dc.subject
Septic arthritis
en
dc.subject
Resection arthroplasty
en
dc.subject
Total hip arthroplasty
en
dc.subject
Periprosthetic infection
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
Total hip arthroplasty for destructive septic arthritis of the hip using a two-stage protocol without spacer placement
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.doi
10.1007/s00402-021-03981-2
dcterms.bibliographicCitation.journaltitle
Archives of Orthopaedic and Trauma Surgery
dcterms.bibliographicCitation.number
1
dcterms.bibliographicCitation.originalpublishername
Springer Nature
dcterms.bibliographicCitation.pagestart
19
dcterms.bibliographicCitation.pageend
28
dcterms.bibliographicCitation.volume
143
refubium.affiliation
Charité - Universitätsmedizin Berlin
refubium.funding
Springer Nature DEAL
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.bibliographicCitation.pmid
34097122
dcterms.isPartOf.eissn
1434-3916