Short-term results following two-stage revision for periprosthetic joint infection

Abstract

Background: Hip and knee arthroplasty procedures are successful surgical procedures, with total hip arthroplasty being named the operation of the 20th century. With there being an estimated rate globally of periprosthetic joint infection of 1% for hips and 2% for knees, this minimal infection rate represents a large global concern. The successful management of periprosthetic joint infection remains controversial with multiple proposed strategies. Our aim is to present our short-term data for a two-stage revision protocol. Methods: A single centre retrospective review of an existing database starting from January 2013 and including April 2019 was conducted looking at patients having undergone two-stage revision for periprosthetic joint infection. The unit utilised a standard approach to two-stage revisions. Data was collected from the existing database to ascertain short-term success based on the Delphibased international multidisciplinary consensus criteria. Results: A total of 2 125 entries were reviewed from the database comprising 1 912 primary arthroplasty procedures. From all revision cases 19 patients were identified to have undergone a two-stage revision by our unit. Of these patients we managed to collect sufficient data to gauge treatment success in 12 patients. Of these 12 patients with a mean follow-up of 25.6 months, ten reported complete wound healing, pain improvement and no subsequent surgery. One patient demised from septic complications and one required subsequent arthrodesis which controlled the sepsis. Conclusion: Our results showed a high infection eradication rate following our two-staged revision protocol despite frequent delays between first and second stages as a result of resource constraints and limitations. Level of evidence: Level 4