Repeat 2-Stage Revision for Recurrent Infection of Total Hip Arthroplasty

被引:30
作者
Kalra, Kunal P. [1 ]
Lin, Kirk K. [1 ]
Bozic, Kevin J. [1 ]
Ries, Michael D. [1 ]
机构
[1] Univ Calif San Francisco, Dept Orthoped Surg, San Francisco, CA 94131 USA
关键词
total hip arthroplasty; infection; revision; cement; spacer; STRUCTURAL ALLOGRAFT; BONE ALLOGRAFTS; REIMPLANTATION; REPLACEMENTS; CEMENT; FEMUR;
D O I
10.1016/j.arth.2009.12.010
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Eleven patients who developed reinfection after 2-stage revision for infected total hip arthroplasty (THA) were treated with a repeat 2-stage rerevision. Of the 11 rerevisions, 4 were successful, with no recurrent infection at mean follow-up of 44 months. Reinfection occurred in 7 patients of whom 6 involved either a significantly compromised host or poor local wound status. Clinical symptoms of infection were controlled in 4 of the 7 reinfected cases with antibiotic therapy in 2, irrigation and debridement in 1, and a third 2-stage revision THA in 1. Repeat 2-stage treatment of infected THA is associated with a high failure rate. However, successful results can be achieved particularly if the host is not immunocompromised and healthy soft tissue coverage is present.
引用
收藏
页码:880 / 884
页数:5
相关论文
共 24 条
[1]   Structural allograft in two-stage revisions for failed septic hip arthroplasty [J].
Alexeeff, M ;
Mahomed, N ;
Morsi, E ;
Garbuz, D ;
Gross, A .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1996, 78B (02) :213-216
[2]   Allograft bone in two-stage revision of the hip for infection - Is it safe? [J].
Ammon, P ;
Stockley, I .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 2004, 86B (07) :962-965
[3]   Vancomycin-supplement impacted bone allografts in infected hip arthroplasty - Two-stage revision results [J].
Buttaro, MA ;
Pusso, R ;
Piccaluga, F .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 2005, 87B (03) :314-319
[4]  
Della Valle CJ, 2004, CLIN ORTHOP RELAT R, P55
[5]   Impaction grafting of the femur in two-stage revision for infected total hip replacement [J].
English, H ;
Timperley, AJ ;
Dunlop, D ;
Gie, G .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 2002, 84B (05) :700-705
[6]   Patient-related risk factors for early revision of total hip replacements - A population register-based case-control study of 674 revised hips [J].
Espehaug, B ;
Havelin, LI ;
Engesaeter, LB ;
Langeland, N ;
Vollset, SE .
ACTA ORTHOPAEDICA SCANDINAVICA, 1997, 68 (03) :207-215
[7]   Two-stage uncemented revision hip arthroplasty for infection [J].
Haddad, FS ;
Muirhead-Allwood, SK ;
Manktelow, ARJ ;
Bacarese-Hamilton, I .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 2000, 82B (05) :689-694
[8]   Structural proximal femoral allografts for failed total hip replacements - A minimum review of five years [J].
Haddad, FS ;
Garbuz, DS ;
Masri, BA ;
Duncan, CP .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 2000, 82B (06) :830-836
[9]   Practical applications of antibiotic-loaded bone cement for treatment of infected joint replacements [J].
Hanssen, AD ;
Spangehl, MJ .
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2004, (427) :79-85
[10]  
Hanssen AD, 2004, CLIN ORTHOP RELAT R, P63