Comparison of Patient Reported Outcome Measures After Single Versus Two-stage Revision for Chronic Infection of Total Hip Arthroplasty: a Retrospective Propensity Score Matched Cohort Study

Overview

Journal Arch Orthop Trauma Surg

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2021 Mar 30

PMID 33783636

Citations 9

Authors

Venkatsaiakhil Tirumala

Christian Klemt

Janna van den Kieboom

Liang Xiong

Young-Min Kwon

Affiliations

Soon will be listed here.

Abstract

Introduction: Two-stage revision is the current gold standard treatment for infected total hip arthroplasties (THA) with good clinical outcomes. Single-stage revision THA offers the advantage of only a single surgical intervention, potentially leading to improved functional outcomes. This study aimed to compare the differences in patient-reported outcome measures (PROMs) and complications between single and two-stage revision THA for chronic periprosthetic joint infection (PJI).

Methods: A total of 159 consecutive revision THA patients for chronic PJI with complete pre-and post-operative patient-reported outcome measures (PROM) was investigated. A total of 46 patients with single-stage revision THA was matched to 92 patients following two-stage revision THA using propensity score matching, yielding a total of 136 propensity score-matched patients for analysis.

Results: Single and two-stage revision THA improved PROM scores post-operatively, with significantly higher PROMs for single-stage revision THA (HOOS-PS: 50.7 vs 46.4, p = 0.04; Physical SF 10A: 42.1 vs 36.6, p < 0.001; PROMIS SF Physical: 41.4 vs 37.4, p < 0.001; PROMIS SF Mental: 52.8 vs 47.6, p < 0.001). There was no significant difference between both cohorts for reinfection rates (p = 0.81) and 90-day mortality rates (p = 1.0).

Conclusion: This study found a demonstrable functional benefit of single-stage revision compared to two-stage revision for THA with chronic periprosthetic joint infection, suggesting that single-stage revision THA may provide an effective alternative to two-stage revision in selected patients with chronic PJI.

Level Of Evidence: Level III, case-control retrospective analysis.

Citing Articles

Comparative reinfection rate of one-stage versus two-stage revision in the management of periprosthetic joint infection following total hip arthroplasty: a meta-analysis.

Qin Y, Liu Z, Li L, Yang Y, Huang X, Liang W BMC Musculoskelet Disord. 2024; 25(1):1056.

PMID: 39707249 PMC: 11660438. DOI: 10.1186/s12891-024-08199-y.

Clinical outcomes and survival rates of a uncemented modular revision stem system in hip arthroplasty: a 10-year single-institution study on a frail population.

De Meo D, Martini P, Perciballi B, Guarascio G, Vacca M, Cera G Arch Orthop Trauma Surg. 2024; 144(8):3833-3840.

PMID: 39126455 PMC: 11417061. DOI: 10.1007/s00402-024-05483-3.

Systematic review and meta-analysis of single-stage vs two-stage revision for periprosthetic joint infection: a call for a prospective randomized trial.

Zhao Y, Fan S, Wang Z, Yan X, Luo H BMC Musculoskelet Disord. 2024; 25(1):153.

PMID: 38373976 PMC: 10875807. DOI: 10.1186/s12891-024-07229-z.

Optimizing vancomycin release from novel carbon fiber-reinforced polymer implants with small holes: periprosthetic joint infection treatment.

Kamihata S, Ando W, Nakahara I, Enami H, Takashima K, Uemura K J Artif Organs. 2023; 27(3):269-276.

PMID: 37266841 DOI: 10.1007/s10047-023-01407-x.

Single-stage revision for chronic periprosthetic joint infection after knee and hip arthroplasties: indications and treatments.

Mu W, Ji B, Cao L Arthroplasty. 2023; 5(1):11.

PMID: 36864484 PMC: 9979399. DOI: 10.1186/s42836-023-00168-5.

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