High re-revision rate following one-stage exchange for streptococcal periprosthetic joint infection of the hip. Issue 4 (July 2022)

• Record Type: Journal Article
• Authors: Ohlmeier, Malte; Jachczik, Insa; Citak, Mustafa; Gehrke, Thorsten; Hawi, Nael; Haasper, Carl; Abdelaziz, Hussein
• Is Part Of: Hip international. Volume 32:Issue 4(2022)
• Page Start: 488
• Page End: 492
• Publication Date: 2022-07
• Subjects: One-stage exchange -- periprosthetic joint infection -- single-stage revision -- Streptococci -- total hip arthroplasty; Hip joint -- Pathophysiology -- Periodicals; Hip joint -- Diseases -- Periodicals; Hip joint -- Surgery -- Periodicals; 617.581005
• DOI: 10.1177/1120700021991467
• Languages: English
• ISSNs: 1120-7000

Abstract

Introduction: This study was undertaken to analyse the outcome of 1-stage exchange in the management of streptococcal periprosthetic joint infection (PJI) of the hip at a single hospital. Methods: We identified 30 patients with a streptococcal PJI of the hip who had been treated by 1-stage exchange at our hospital between 2002 and 2017. Postoperative complications and the need for any subsequent re-revision for infection or other reasons were analysed. The Harris Hip Score (HHS) was evaluated at final follow-up. Results: The mean follow-up was 8.2 years (SD 4.1). The overall re-revision rate for any reason was 53% (16/30) at a mean 5.3 years (SD 0.68 years). Re-revision for infection was 20% (6/30) at a mean 1.8 years (SD 0.74 years). All re-revisions for PJI (6/6; 100%) were for relapse of the streptococcal infection. At final follow-up, the mean HHS was 68 points (SD 20). Conclusions: The rate of re-revision after 1-stage exchange for streptococcal PJI is high. Eradication of a streptococcal PJI of the hip remains challenging. Further extensive and comparative studies between 1-and 2-stage exchange are encouraged.