EFFICIENCY OF THE FIRST STAGE OF TWO-STAGED REVISION SURGERY IN PATIENTS WITH PERIPROSTHETIC HIP INFECTION

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Abstract

Objective - to evaluate the effectiveness of the first phase of a two-stage method of surgical treatment of periprosthetic infection and to identify possible factors influencing the outcomes. Material and methods. The analysis of results of treatment of 217 patients with infection operated in 2008-2012. The mean age was 56.1 years (95% CI 48.3 to 67.4). All patients underwent surgery with removal of hip endoprosthesis and installation block or articulating spacers at different times after the primary (77%) or revision (23%) arthroplasty. Results. Relapse of infection was detected in 78 cases (35.9%). In 139 (64.1%) patients remission of infection was observed, which allowed an average of 10.2 weeks (95% CI 7.87 to 14.3) perform a full-fledged replacement for a spacer prosthesis. Relapse of infection was detected in 78 (35.9%) cases. Conclusion. The main risk factors leading to a recurrence of the infection are the combination and type of microorganism, laboratory parameters, weight of the patient and the type of previous surgery.

About the authors

B. Lyu

Vreden Russian Research Institute for Traumotology and Orthopedics

Author for correspondence.
Email: info@rniito.ru
Россия

R. M. Tikhilov

Vreden Russian Research Institute for Traumotology and Orthopedics; Mechnikov Northwestern State Medical University

Email: info@rniito.ru
Россия

I. I. Shubnyakov

Vreden Russian Research Institute for Traumotology and Orthopedics

Email: info@rniito.ru
Россия

V. L. Razorenov

Vreden Russian Research Institute for Traumotology and Orthopedics

Email: info@rniito.ru
Россия

A. O. Denisov

Vreden Russian Research Institute for Traumotology and Orthopedics

Email: med-03@yandex.ru
Россия

S. A. Bozhkova

Vreden Russian Research Institute for Traumotology and Orthopedics

Email: clinpharm-rniito@yandex.ru
Россия

V. A. Artyukh

Vreden Russian Research Institute for Traumotology and Orthopedics

Email: artyukhva@mail.ru
Россия

O. A. Klitsenko

Mechnikov Northwestern State Medical University

Email: olkl@yandex.ru
Россия

Z. A. Totoev

Vreden Russian Research Institute for Traumotology and Orthopedics

Email: zaurbek.totoev@ya.ru
Россия

References

  1. Божкова С.А., Тихилов Р.М., Разоренов В.Л., Чуприс В.Г., Петрова Т.М. Микробиологические аспекты антибактериальной терапии парапротезной инфекции, вызванной грамположительными возбудителями. Инфекции в хирургии. 2011; 9(3):31-36.
  2. Божкова С.А., Тихилов Р.М., Краснова М.В., Рукина А.Н. Ортопедическая имплантат-ассоциированная инфекция: ведущие возбудители, локальная резистентность и рекомендации по антибактериальной терапии. Травматология и ортопедия России. 2013; (4):5-15.
  3. Лю Бо, Тихилов Р.М., Шубняков И.И., Божкова С.А., Артюх В.А., Денисов А.О. Анализ эффективности санирующих операций при параэндопротезной инфекции. Травматология и ортопедия России. 2014; (2):22-29.
  4. Материалы международной согласительной конференции по перипротезной инфекции [Proceeding of the International Consensus Conference on periprosthetic infection]. Дж. Парвизи, Т. Герке. Пер. с англ. под ред. проф. Р.М. Тихилова. СПб.: РНИИТО им. Р.Р. Вредена; 2014. 355 с.
  5. Сергиенко В.И., Бондарева И.Б. Математическая статистика в клинических исследованиях. М.: ГЭОТАР-Медицина; 2000. 256 с
  6. Тихилов Р.М., Шаповалов В.М. (ред.) Руководство по эндопротезированию тазобедренного сустава. СПб.: РНИИТО им. Р.Р. Вредена, 2008. 324 с.
  7. Тихилов Р.М., Шубняков И.И., Коваленко А.Н., Тотоев З.А., Лю Бо, Билык С.С. Структура ранних ревизий эндопротезирования тазобедренного сустава. Травматология и ортопедия России. 2014; (2):5-13.
  8. Anagnostakos K., Schmid N.V., Kelm J. et al. Classification of hip joint infections. Int. J. Med. Sci. 2009; 6:227-233.
  9. Berbari E.F., Osmon D.R., Duffy M.C.T. et al. Outcome of prosthetic joint infection in patients with rheumatoid arthritis: the impact of medical and surgical therapy in 200 episodes. Clin. Infect. Dis. 2006; 42:216-223.
  10. Berend K.R., Lombardi A.V. Jr., Morris M.J. et al. Two-stage treatment of hip periprosthetic joint infection is associated with a high rate of infection control but high mortality. Clin. Orthop. 2013; 471:510-518.
  11. Bejon P., Berendt A., Atkins B.L. et al. Two-stage revision for prosthetic joint infection: predictors of outcome and the role of reimplantation microbiology. J. Antimicrob. Chemother. 2010; 65:569-575.
  12. Betsch B.Y., Eggli S., Siebenrock K.A. et al. Treatment of joint prosthesis infection in accordance with current recommendations improves outcome. Clin. Infect. Dis. 2008; 46:1221-1226.
  13. Bongartz T., Halligan C.S., Osmon D.R. et al. Incidence and risk factors of prosthetic joint infection after total hip or knee replacement in patients with rheumatoid arthritis. Arthritis Rheum. 2008; 59:1713-1720.
  14. Bozic K.J., Ries M.D. The impact of infection after total hip arthroplasty on hospital and surgeon resource utilization. J. Bone Joint Surg. Am. 2005; 87:1746-1751.
  15. Charlson M.E., Pompei P., Ales K.L. et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J. Chronic Dis. 1987; 40:373-383.
  16. Choi H.R., Beecher B., Bedair H. Mortality after septic versus aseptic revision total hip arthroplasty: a matchedcohort study. J. Arthroplasty. 2013; 28(8 Suppl.):56-58.
  17. Dripps R.D., Lamont A., Eckenhoff J.E. The role of anesthesia in surgical, mortality. JAMA. 1961; 178:261-266.
  18. Esposito S., Leone S. Prosthetic joint infections: microbiology, diagnosis, manage- ment and prevention. Int. J. Antimicrob. Agents. 2008; 32:287-293.
  19. Ethgen O., Bruyere O., Richy F. et al. Health-related quality of life in total hip and total knee arthroplasty. A qualitative and systematic review of the literature. J. Bone Joint Surg. Am. 2004; 86:963-974.
  20. Giulieri S.G., Graber P., Ochsner P.E. et al. Management of infection associated with total hip arthroplasty according to a treatment algorithm. Infection 2004; 32:222-228.
  21. Hanssen A., Osmon D. Evaluation of a staging system for infected arthroplasty. Clin. Orthop. 2002; 403:16-22.
  22. Hirvonen J., Blom M., Tuominen U. et al. Health related quality of life in patients waiting for major joint replacement. A comparison between patients and population controls. Health Qual. Life Outcomes. 2006; 4:3-7.
  23. Katz J.N., Losina E., Barrett J. et al. Association between hospital and surgeon procedure volume and outcomes of total hip replacement in the United States Medicare population. J. Bone Joint Surg. Am. 2001; 83:1622-1629.
  24. Kilgus D.J., Howe D.J., Strang A. Results of periprosthetic hip and knee infections caused by resistant bacteria. Clin. Orthop. 2002; 404:116-124.
  25. Klouche S., Sariali E., Mamoudy P. Total hip arthroplasty revision due to infection: a cost analysis approach. Orthop. Traumatol. Surg. Res. 2010; 96:124-132.
  26. Kurtz S.M., Lau E., Schmier J. et al. Infection burden for hip and knee arthroplasty in the United States. J. Arthroplasty. 2008; 23:984-991.
  27. Lichstein P., Gehrke T., Lombardi A. et al. One-stage vs two-stage exchange. J. Arthroplasty. 2014; 29(2 Suppl.):108-111.
  28. Mankin H.J., Lange T.A., Spanier S.S. The hazards of biopsy in patients with malignant primary bone and soft-tissue tumors. J. Bone Joint Surg. Am. 1982; 64:1121-1127.
  29. Mankin H.J., Mankin C.J., Simon M.A. The hazards of biopsy revisited. J. Bone Joint Surg. Am. 1996; 78:656-663.
  30. Marculescu C., Cantey J.E. Polymicrobial prosthetic joint infections: risk factors and outcome. Clin. Orthop. 2008; 466:1397-1404.
  31. Moran E., Byren I., Atkins B.L. The diagnosis and management of prosthetic joint infections. J. Antimicrob. Chemother. 2010; 65:45-54.
  32. Ong K.L., Kurtz S.M., Lau E. et al. Prosthetic joint infection risk after total hip arthroplasty in the Medicare population. J. Arthroplasty. 2009; 24:105-109.
  33. Pulido L., Ghanem E., Joshi A. et al. Periprosthetic joint infection: the incidence, timing, and predisposing factors. Clin. Orthop. 2008; 466:1710-1715.
  34. Phillips J.E., Crane T.P., Noy M. et al. The incidence of deep prosthetic infections in a specialist orthopaedic hospital: a 15-year prospective survey. J. Bone Joint Surg. Br. 2006; 88:943-948.
  35. Salgado C.D., Dash S., Cantey J.R. et al. Higher risk of failure of methicillin-resistant Staphylococcus aureus prosthetic joint infections. Clin. Orthop. 2007; 461:48-53.
  36. Schmalzried T.P. The infected hip: telltale signs and treatment options. J. Arthroplasty 2006; 21:97-100.
  37. Widmer A. New developments in diagnosis and treatment of infection in orthopedic implants. Clin. Infect. Dis. 2001; 33:S94-106.
  38. Volin S.J., Hinrichs S.H., Garvin K.L. Two-stage reimplantation of total joint infections: a comparison of resistant and non-resistant organisms. Clin. Orthop. 2004; 427:94-100.

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