Salvage Procedures for Management of Prosthetic Joint Infection After Hip and Knee Replacements

Mahmoud, Samer S.S.; Sukeik, Mohamed; Alazzawi, Sulaiman; Shaath, Mohammed; Sabri, Omar

doi:10.2174/1874325001610010600

Cited by 21 publications

(14 citation statements)

References 94 publications

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“…For example, in culture negative and resistant organisms, diagnosis can be challenging, but once established using all the diagnostic tools available and applying the International Consensus Meeting (ICM) on management of PJIs diagnostic criteria [12], treatment strategies should follow a two-stage reimplantation procedure as debridement and exchange of mobile parts and single-stage revisions are associated with higher failure rates [18,[46][47][48][49]. Patients who fail treatment may require salvage procedures such as long-term antibiotics, resection arthroplasty, fusion and amputation [50].…”

Section: Discussionmentioning

confidence: 99%

Periprosthetic joint infections after total hip replacement: an algorithmic approach

Sukeik

Haddad

2019

SICOT-J

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An algorithm for managing periprosthetic joint infections (PJIs) after total hip replacement (THR) surgery using a multidisciplinary approach and a clearly defined protocol may improve infection eradication rates. In this article, we present an algorithm for the management of different types of PJIs including the acutely infected cemented and cementless THRs where the components are well-fixed postoperatively and when the infection is secondary to haematogenous spread in previously well-functioning and well-fixed implants. For chronic PJIs where the components are often loose, the standard treatment includes a two-stage revision procedure. However, in a highly selected subset of patients, a single-stage approach has been utilised with high rates of eradicating infections.

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Section: Discussionmentioning

confidence: 99%

Periprosthetic joint infections after total hip replacement: an algorithmic approach

Sukeik

Haddad

2019

SICOT-J

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“…Antibiotic-coated hip spacer for periprosthetic infection treatment are described in detail in the literature [2] , [4] , [5] , [7] , [8] , [10] , [12] , [20] , [21] , as well as the use of antibiotic-coated intramedullary nails for infected long bones fractures or infected nonunions [13] , [14] , [16] , [17] , [22] , [23] . However, there are few reports describing therapeutic options applied to cases in which a deficit of proximal bone stock of the femur coexist with a femur shaft defect (fracture or nonunion) in the context of an infection; most of them were case reports about a single and unique salvage technique.…”

Section: Discussionmentioning

confidence: 99%

Preliminary outcomes of proximal femur megaspacers

et al. 2019

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There are very few therapeutic alternatives for patients with proximal femoral epiphyseal bone deficit combined with a fracture at another level and signs of infection. This combination can be successfully managed with a proximal femur megaspacer. This article is intended to review our variation of this technique and to show the initial results obtained from 11 cases. Of these 11 cases, there were 6 women and 5 men. The mean age was 66 years. The average number of previous surgeries was 3. Definitive prosthetic reconstructive treatment was achieved in 7 of these 11 subjects. The average time to reimplantation was 11.7 months. Fractures or nonunion healed uneventfully. Bone union and infection control were achieved in 10 of the 11 patients.

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“…Additionally, patients that undergo GRA are generally not deemed fit for a single- or two-stage revision of a total hip replacement due to their age and multiple comorbidities. As this patient group already has significant functional disabilities, a GRA procedure will undoubtedly lead to a critical situation that makes patients functionally dependent in their daily activities 8, 11, 27. As they are less ambulant which may result in a restricted freedom of maintaining the daily lifestyle, influencing their psychological wellbeing.…”

Section: Discussionmentioning

confidence: 99%

Quality of life and health status after Girdlestone resection arthroplasty in patients with an infected total hip prosthesis

Vincenten

Oudsten

Bos

et al. 2019

J. Bone Joint Infect.

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Introduction: The Girdlestone resection arthroplasty (GRA) is a salvage procedure for a recurrent or persistent prosthetic joint infection of the hip. This procedure negatively impacts the functional outcome and presumably also diminishes health status (HS) and quality of life (QOL). However, studies investigating the QOL after GRA are lacking. This cross-sectional study compares patients with a Girdlestone situation after an infected total hip prosthesis with a normative population with regard to HS and QOL.Methods: Patients with a permanent GRA were suitable to be enrolled in the study. Subjects completed the World Health Organization Quality of life (WHOQOL-BREF) and the EuroQol 5 dimension 3 level version (EQ-5D-3L). Scores were compared with data from the normal population, from patients with a lower limb amputations and data from patients with a myocardial infarction.Results: Sixty-three patients who underwent GRA between January 2000 and March 2017 completed the questionnaire. The median time between the GRA and competing the questionnaire was 48 months (4 -436). All WHOQOL-BREF domain scores were significantly lower in GRA patients compared to the normative data (p<0.001), patients with myocardial infarction or lower limb amputation. EQ-5D-3L results showed that HS was significantly impaired in GRA patients when compared to normative data (p<0.001) and also impaired when compared to data from lower limb amputations and myocardial infarctions.Conclusion: HS and QOL scores in patients with a permanent Girdlestone situation after an infected hip prosthesis are significantly lower than Dutch normative scores. Patients with a permanent Girdlestone situation scored even lower on HS than patients with a lower limb amputation or a myocardial infarction.

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Salvage Procedures for Management of Prosthetic Joint Infection After Hip and Knee Replacements

Cited by 21 publications

References 94 publications

Periprosthetic joint infections after total hip replacement: an algorithmic approach

Periprosthetic joint infections after total hip replacement: an algorithmic approach

Preliminary outcomes of proximal femur megaspacers

Quality of life and health status after Girdlestone resection arthroplasty in patients with an infected total hip prosthesis

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