Preliminary Results After Changing From Two-Stage to One-Stage Revision Arthroplasty Protocol Using Cementless Arthroplasty for Chronic Infected Hip Replacements

Bori, Guillem; Navarro, Guillem; Morata, Laura; Fernández-Valencia, Jenaro Á.; Soriano, Álex; Gallart, Xavier

doi:10.1016/j.arth.2017.08.033

Cited by 21 publications

(13 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Up until September 2015, in Hospital Clínic de Barcelona, chronic knee PJI had been treated with 2-stage revision surgery. Studies in the past few years have indicated that (1) clinical results in terms of reinfection or chronic infection in 2-stage revision do not show great differences with the 1-stage revision [ 10 , 12 , 14 , 16 ]; (2) the results in terms of functional outcomes and quality of life have been shown to be better for 1-stage revision than for 2-stage revision [ 15 , 17 ]; (3) the results in our hospital for 1-stage THA revisions were better than for 2-stage THA revisions [ 18 , 19 , 20 ]; and (4) there was an organizational change in the orthopedic surgery and traumatology team, and chronic knee and hip PJI went from being treated in different departments to being treated by the same team of surgeons with experience in 1-stage and complex knee revision. This organizational change led our hospital to modify its treatment protocol for chronic knee PJI from the 2-stage approach to the 1-stage approach.…”

Section: Methodsmentioning

confidence: 99%

Experiences during Switching from Two-Stage to One-Stage Revision Arthroplasty for Chronic Total Knee Arthroplasty Infection

et al. 2021

Self Cite

View full text Add to dashboard Cite

The objective of this study was to evaluate our preliminary results after changing our surgical strategy from 2-stage revision arthroplasty to 1-stage revision arthroplasty for patients with chronic knee periprosthetic joint infection. We conducted a prospective study of knee arthroplasty patients that had been diagnosed with chronic infection and treated using a 1-stage revision regardless of the traditional criteria applied for indication thereof. We evaluated two main variables: infection control and economic costs. The definitive diagnosis of infection of the revision was determined by using the criteria proposed by the Musculoskeletal Infection Society. The costs were calculated as average costs in USD, as described by Srivastava (2019), for 1-stage or 2-stage revisions. Eighteen patients were included in the study, and infection was controlled in 17 patients. The total economic savings for our hospital from these 18 patients amounted to USD 291,152. This clinical success has led to major changes in how our hospital approaches the treatment of chronically infected knee replacements, in addition to substantial economic advantages for the hospital.

show abstract

Section: Methodsmentioning

confidence: 99%

Experiences during Switching from Two-Stage to One-Stage Revision Arthroplasty for Chronic Total Knee Arthroplasty Infection

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…обсуждение Поскольку ППИ является проблемой как для пациента, так и для оперирующего хирурга, существуют различные подходы к тактике оперативного лечения ППИ. В последнее время все больше авторов склоняются к одноэтапной тактике лечения [30,31,32]. В нашем исследовании было два случая одноэтапных ревизий у пациентов с ранней ППИ, обратившихся в сроки менее 4 недель от ее начала.…”

Section: статистический анализunclassified

“…Этот метод отнесен нами к наиболее чувствительным в плане идентификации микроорганизмов, защищенных микробными биопленками [20,21,22]. При пункции сустава положительный микробиологический посев для установки диагноза ППИ достигает лишь 93% [30], для тканевых биоптатов чувствительность метода колеблется от 65 до 94% [24]. на наш взгляд, исследование уровня цитоза синовиальной жидкости, как на этапе диагностики ППИ, так и на этапе контроля лечения, имеет немаловажное значение.…”

Section: таблица 4 исходы лечения ппиunclassified

“…Сроки наблюдения рассчитывались как среднее арифметическое количества месяцев от момента проведенной на втором этапе санации операции до контрольного осмотра пациента и составили в среднем 11 мес. [95% ДИ[24][25][26][27][28][29][30]. Дизайн исследования представлен на рисунке 3.…”

unclassified

See 1 more Smart Citation

Treatment of Periprosthetic Infection with Silver-Doped Implants Based on Two-Dimensionally Ordered Linear Chain Carbon

Николаев

Lyubimova²,

Любимова³

et al. 2019

Traumatology and Orthopedics of Russia

View full text Add to dashboard Cite

Relevance. Formation of pan-resistance microorganisms, microbial biofilms on implants and recurrent infection rate stimulate the search for optimal prosthesis materials for treatment of periprosthetic infection (PJI). Purpose of the study — to compare the efficiency of two stage PJI treatment with simultaneous implantation of a spacer in combination with implants with silver-doped coatings based on two-dimensionally ordered linear chain carbon (TDOLCC+Ag) during the first stage and the conventional revision with a spacer only. Materials and methods. The study included 72 patients with PJI of the knee (n = 42) and hip (n = 30) joints. Control group (conventional revision) consisted of 35 patients and the main group (TDOLCC+Ag coated implant incorporated in a spacer) — 37 patients. Mean age of the patients was 61 years. Temporary components were replaced by the final components during revision at the second stage. Evaluation methods: clinical, X-ray, laboratory, microbiological and follow up history. Results. Inflammation markers and synovial fluid cytosis in the groups at the first revision stage featured equal high base values. During the second stage leucocyte count and cytosis reached normal values, ESR decreased twofold in both groups, CRP decreased five times in the main group. Throat and nasal swabs demonstrated growth of Staphylococcus aureus at 24,3-32,4% in both groups. The leading inducer of PJI was staphylococcal flora with MRSA share of 7,1% and MRSE — from 62,5 to 66,7%. End-points of evaluating treatment outcomes were revision spacer implantation at the second stage of sanation and recurrent PJI. Control group featured implantation of more revision spacers (5) as compared to the main group (1) after the treatment. Two recurrent PJIs were reported for the control group in 11 months while no recurrent infection was reported for the main group. Conclusion. The study demonstrated statistically significant improvement in the outcomes of PJI treatment by spacers with implants coated by TDOLCC+Ag as compared to the conventional treatment option.

show abstract

“…This is a one-stage revision, when the implant is removed at the same time, debridement is performed, after which the implantation of a new endoprosthesis is performed. According to various authors, its effectiveness ranges from 70 to 96% (Bori et al, 2018;Kunutsor et al, 2018;Zahar et al, 2019). The next method, which shows high efficiency, is considered a two-stage revision (Kunutsor et al, 2018;Petis et al, 2019;Sigmund et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Infectious complications of hip arthroplasty

Pidhaietskyi

Gayko

Kozak

et al. 2021

ijhs

View full text Add to dashboard Cite

The objective of the research is to study the causes and outcomes of infectious complications after total hip arthroplasty. The background of the research is the analysis of outcomes of 364 patients with complications after total hip arthroplasty; 369 cases, from 2005 to 2018. The infectious complications accounted for 21.7% (80 cases). The work involves clinical, radiological, microbiological, and statistical research methods. As a result of research causes of suppurative complications after total hip arthroplasty were: chronic infectious diseases of internal organs (t=3.37, p=0.001), instability of prosthetic components (t=3.14, p=0.002), over two previous surgical interventions involving the affected joint (t=2.43, p=0.005). In the treatment of periprosthetic infections, sanitizing interventions without the prosthetic components’ removal appeared efficient within only up to 3 weeks. If the sanitizing interventions were inconclusive, the double-stage revision prosthetics appeared adequate in a reliable number of cases (t = 11.2, p = 0.0028), namely 24, which amounted to 92.3%. In conclusion, it was concluded that the causes of periprosthetic infections were: diseases of the internal organs, instability of the components, over two surgical operations involving the same joint. The development of various complications after total hip replacements demands surgical revision procedures.

show abstract

Preliminary Results After Changing From Two-Stage to One-Stage Revision Arthroplasty Protocol Using Cementless Arthroplasty for Chronic Infected Hip Replacements

Cited by 21 publications

References 24 publications

Experiences during Switching from Two-Stage to One-Stage Revision Arthroplasty for Chronic Total Knee Arthroplasty Infection

Experiences during Switching from Two-Stage to One-Stage Revision Arthroplasty for Chronic Total Knee Arthroplasty Infection

Treatment of Periprosthetic Infection with Silver-Doped Implants Based on Two-Dimensionally Ordered Linear Chain Carbon

Infectious complications of hip arthroplasty

Contact Info

Product

Resources

About