THE TREATMENT OF INFECTIOUS COMPLICATIONS AFTER HIP REPLACEMENTV

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Abstract

Purpose of the study – to estimate the effectiveness of periprosthetic infection of the hip using different modifications of spacers. Material and methods. The authors analyzed treatment outcomes of 168 patients with clinical and laboratory signs of infection after hip replacement. Patients were divided into two groups: 87 patients (control group) underwent a standard two-stage revision hip joint arthroplasty with a spacer; 81 patients (test group) underwent preoperative examination procedure suggested by authors that was the basis for future selection of surgical technique using various spacers and customized follow up treatment. Results. The authors observed in test group a marked reduction of microbial contamination of periprosthetic tissue: 1 month after spacer implantation the test group features four times less pathogens as compared to control group. Need for re-revision was decreased by 1.8 times, twofold decrease in need for spacer revision after secondary examination, 1,4 less duration of hospital stay and 1,8 less disability duration was observed as compared to outcomes in control group after standard treatment approach. Functional outcomes of patients in test group in 6 months after secondary examination in regard of infectious complication after hip replacement were characterized by better Harris Hip scores as compared to control group. 6-12 months after revision the patients of test group were 1.3 times less reporting limitations of functional activity, twice less using support means and 2.2 times less needed pain medication. Conclusion. Complex treatment that includes preoperative examination, evaluation of bone defect volume, algorithm of choosing the antibiotic spacer type and its implantation technique as well as customized postoperative follow up treatment was proved to be efficient and results in stable eradication of chronic suppurative inflammation.

About the authors

R. N. Komarov

Privolzhsky Federal Research Medical Centre of the Ministry of Health 18, Verkhne-Volzhskaya nab., Nizhny Novgorod, 603155, Russia

Author for correspondence.
Email: bagsnn@gmail.com
Junior Researcher Scientist Department of Purulent Surgery Россия

V. N. Mitrofanov

Privolzhsky Federal Research Medical Centre of the Ministry of Health 18, Verkhne-Volzhskaya nab., Nizhny Novgorod, 603155, Russia

Email: bagsnn@gmail.com
Cand. Sci. (Med) Head of Department of Purulent Surgery Россия

A. V. Novikov

Privolzhsky Federal Research Medical Centre of the Ministry of Health 18, Verkhne-Volzhskaya nab., Nizhny Novgorod, 603155, Russia

Email: bagsnn@gmail.com
Dr. Sci. (Med), Trauma and Orthopedic Surgeon Россия

S. B. Korolev

Privolzhsky Federal Research Medical Centre of the Ministry of Health 18, Verkhne-Volzhskaya nab., Nizhny Novgorod, 603155, Russia
Novgorod State Medical Academy of the Ministry of Public Health
10/1, pl. Minina i Pozharskogo, Nizhny Novgorod, 603155, Russia

Email: bagsnn@gmail.com
Dr. Sci. (Med), professor, the Head of Department of Traumatology, Orthopaedics and Field Surgery, Nizhny Novgorod State Medical Academy; Trauma and Orthopedic Surgeon, Privolzhsky Federal Research Medical Centre of the Ministry of Health Россия

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