Mid-term to long-term outcome and risk factors for failure of 158 hips with two-stage revision for periprosthetic hip joint infection
<p><strong>Introduction</strong>: This study aimed to evaluate infection-free survival and outcomes after two-stage revision surgery for hip periprosthetic joint infection (PJI) performed in a specialised arthroplasty unit over 20 years. <strong>Methods</strong>: We ret...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Copernicus Publications
2025-02-01
|
| Series: | Journal of Bone and Joint Infection |
| Online Access: | https://jbji.copernicus.org/articles/10/15/2025/jbji-10-15-2025.pdf |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1823858428855975936 |
|---|---|
| author | M. Abuelnour C. McNamee A. B. Rafi W. Hohlbein W. Hohlbein P. Keogh J. Cashman |
| author_facet | M. Abuelnour C. McNamee A. B. Rafi W. Hohlbein W. Hohlbein P. Keogh J. Cashman |
| author_sort | M. Abuelnour |
| collection | DOAJ |
| description | <p><strong>Introduction</strong>: This study aimed to evaluate infection-free survival and outcomes after two-stage revision surgery for hip periprosthetic joint infection (PJI) performed in a specialised arthroplasty unit over 20 years. <strong>Methods</strong>: We retrospectively identified 158 hips (154 patients) treated with two-stage revision surgery for hip PJI between 2001 and 2021. We analysed their data and presented their infection-free survival, re-operation rate, mortality, risk factors and complications. <strong>Results</strong>: The mean follow-up time was 9 (2 to 21.7) years. A total of 22 hips (13.9 %) were re-infected. The infection-free survival was 94.4 % at 2 years, 89.3 % at 5 years, 84.2 % at 10 years, and 82.6 % at 15 and 20 years. The re-operation rate for aseptic causes was 12 %, and the most common cause of re-operation was dislocation (7 %). The cumulative survival for re-operation for aseptic causes was 93.6 % at 2 years, 89.7 % at 5 years, 88.8 % at 10 years, and 82.8 % at 15 and 20 years. The cumulative survival for all-cause re-revision was 88.8 % at 2 years, 80.8 % at 5 years, 74.9 % at 10 years, and 68 % at 15 and 20 years. The mean Western Ontario and McMaster Universities Arthritis Index (WOMAC) hip score significantly improved from 68.3 at the pre-operative stage to 35.9 at 2.1 (2 to 3.3) years, 35.3 at 5.3 (5 to 8.4) years, 38.3 at 11.3 (10–15) years and 43.8 at 18.7 (16.5 to 21.7) years (<span class="inline-formula"><i>p</i><0.01</span>). Duration of antibiotics and gram-negative infection were the only predictive risk factors for re-infection. <strong>Conclusion</strong>: Our results of the two-stage revision protocol for hip PJI were satisfactory and comparable with the best reported outcomes.</p> |
| format | Article |
| id | doaj-art-b0a9a1261d534bde8f8840d218fdfb11 |
| institution | Kabale University |
| issn | 2206-3552 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Copernicus Publications |
| record_format | Article |
| series | Journal of Bone and Joint Infection |
| spelling | doaj-art-b0a9a1261d534bde8f8840d218fdfb112025-02-11T11:21:13ZengCopernicus PublicationsJournal of Bone and Joint Infection2206-35522025-02-0110152410.5194/jbji-10-15-2025Mid-term to long-term outcome and risk factors for failure of 158 hips with two-stage revision for periprosthetic hip joint infectionM. Abuelnour0C. McNamee1A. B. Rafi2W. Hohlbein3W. Hohlbein4P. Keogh5J. Cashman6Cappagh National Orthopaedic Hospital, Dublin, Republic of IrelandSchool of Medicine, University College Dublin, Dublin, Republic of IrelandCappagh National Orthopaedic Hospital, Dublin, Republic of IrelandRoMed Klinikum, Rosenheim, GermanyDepartment of Orthopaedics and Traumatology, Paracelsus Medical University, Salzburg, AustriaCappagh National Orthopaedic Hospital, Dublin, Republic of IrelandCappagh National Orthopaedic Hospital, Dublin, Republic of Ireland<p><strong>Introduction</strong>: This study aimed to evaluate infection-free survival and outcomes after two-stage revision surgery for hip periprosthetic joint infection (PJI) performed in a specialised arthroplasty unit over 20 years. <strong>Methods</strong>: We retrospectively identified 158 hips (154 patients) treated with two-stage revision surgery for hip PJI between 2001 and 2021. We analysed their data and presented their infection-free survival, re-operation rate, mortality, risk factors and complications. <strong>Results</strong>: The mean follow-up time was 9 (2 to 21.7) years. A total of 22 hips (13.9 %) were re-infected. The infection-free survival was 94.4 % at 2 years, 89.3 % at 5 years, 84.2 % at 10 years, and 82.6 % at 15 and 20 years. The re-operation rate for aseptic causes was 12 %, and the most common cause of re-operation was dislocation (7 %). The cumulative survival for re-operation for aseptic causes was 93.6 % at 2 years, 89.7 % at 5 years, 88.8 % at 10 years, and 82.8 % at 15 and 20 years. The cumulative survival for all-cause re-revision was 88.8 % at 2 years, 80.8 % at 5 years, 74.9 % at 10 years, and 68 % at 15 and 20 years. The mean Western Ontario and McMaster Universities Arthritis Index (WOMAC) hip score significantly improved from 68.3 at the pre-operative stage to 35.9 at 2.1 (2 to 3.3) years, 35.3 at 5.3 (5 to 8.4) years, 38.3 at 11.3 (10–15) years and 43.8 at 18.7 (16.5 to 21.7) years (<span class="inline-formula"><i>p</i><0.01</span>). Duration of antibiotics and gram-negative infection were the only predictive risk factors for re-infection. <strong>Conclusion</strong>: Our results of the two-stage revision protocol for hip PJI were satisfactory and comparable with the best reported outcomes.</p>https://jbji.copernicus.org/articles/10/15/2025/jbji-10-15-2025.pdf |
| spellingShingle | M. Abuelnour C. McNamee A. B. Rafi W. Hohlbein W. Hohlbein P. Keogh J. Cashman Mid-term to long-term outcome and risk factors for failure of 158 hips with two-stage revision for periprosthetic hip joint infection Journal of Bone and Joint Infection |
| title | Mid-term to long-term outcome and risk factors for failure of 158 hips with two-stage revision for periprosthetic hip joint infection |
| title_full | Mid-term to long-term outcome and risk factors for failure of 158 hips with two-stage revision for periprosthetic hip joint infection |
| title_fullStr | Mid-term to long-term outcome and risk factors for failure of 158 hips with two-stage revision for periprosthetic hip joint infection |
| title_full_unstemmed | Mid-term to long-term outcome and risk factors for failure of 158 hips with two-stage revision for periprosthetic hip joint infection |
| title_short | Mid-term to long-term outcome and risk factors for failure of 158 hips with two-stage revision for periprosthetic hip joint infection |
| title_sort | mid term to long term outcome and risk factors for failure of 158 hips with two stage revision for periprosthetic hip joint infection |
| url | https://jbji.copernicus.org/articles/10/15/2025/jbji-10-15-2025.pdf |
| work_keys_str_mv | AT mabuelnour midtermtolongtermoutcomeandriskfactorsforfailureof158hipswithtwostagerevisionforperiprosthetichipjointinfection AT cmcnamee midtermtolongtermoutcomeandriskfactorsforfailureof158hipswithtwostagerevisionforperiprosthetichipjointinfection AT abrafi midtermtolongtermoutcomeandriskfactorsforfailureof158hipswithtwostagerevisionforperiprosthetichipjointinfection AT whohlbein midtermtolongtermoutcomeandriskfactorsforfailureof158hipswithtwostagerevisionforperiprosthetichipjointinfection AT whohlbein midtermtolongtermoutcomeandriskfactorsforfailureof158hipswithtwostagerevisionforperiprosthetichipjointinfection AT pkeogh midtermtolongtermoutcomeandriskfactorsforfailureof158hipswithtwostagerevisionforperiprosthetichipjointinfection AT jcashman midtermtolongtermoutcomeandriskfactorsforfailureof158hipswithtwostagerevisionforperiprosthetichipjointinfection |