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Erschienen in: International Orthopaedics 5/2009

01.10.2009 | Original Paper

One-stage cementless revision arthroplasty for infected hip replacements

verfasst von: Jeong Joon Yoo, Young Sam Kwon, Kyung-Hoi Koo, Kang Sup Yoon, Young-Min Kim, Hee Joong Kim

Erschienen in: International Orthopaedics | Ausgabe 5/2009

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Abstract

We hypothesised that one-stage cementless revision hip arthroplasty may have advantages and a role in the treatment of selected patients with an infected hip replacement. We retrospectively reviewed all patients with an infected hip replacement treated with one-stage revision using cementless implants. Twelve patients were reviewed and followed up for at least three years (average: 7.2 years, range: 3.3–11.3 years) postoperatively. One recurrence of infection and one aseptic stem loosening were detected during follow-up. Grafted bone, which was used in eight patients, appeared to have united to host bone in all patients. The success rate of treatment was 83.3% when infection recurrence or component loosening were regarded as failure. One-stage revision hip arthroplasty using cementless implants appears to have a role in the treatment of carefully selected patients with an infected hip replacement if meticulous débridement is performed and appropriate antibiotics are properly used.
Literatur
1.
Zurück zum Zitat Callaghan JJ, Katz RP, Johnston RC (1999) One-stage revision surgery of the infected hip. A minimum 10-year followup study. Clin Orthop Relat Res 369:139–143PubMedCrossRef Callaghan JJ, Katz RP, Johnston RC (1999) One-stage revision surgery of the infected hip. A minimum 10-year followup study. Clin Orthop Relat Res 369:139–143PubMedCrossRef
2.
Zurück zum Zitat Eisler T, Svensson O, Iyer V, Wejkner B, Schmalholz A, Larsson H, Elmstedt E (2000) Revision total hip arthroplasty using third-generation cementing technique. J Arthroplasty 15:974–981PubMedCrossRef Eisler T, Svensson O, Iyer V, Wejkner B, Schmalholz A, Larsson H, Elmstedt E (2000) Revision total hip arthroplasty using third-generation cementing technique. J Arthroplasty 15:974–981PubMedCrossRef
3.
Zurück zum Zitat Engh CA, Massin P, Suthers KE (1990) Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop Relat Res 257:107–128PubMed Engh CA, Massin P, Suthers KE (1990) Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop Relat Res 257:107–128PubMed
4.
Zurück zum Zitat Garvin KL, Evans BG, Salvati EA, Brause BD (1994) Palacos gentamicin for the treatment of deep periprosthetic hip infections. Clin Orthop Relat Res 298:97–105PubMed Garvin KL, Evans BG, Salvati EA, Brause BD (1994) Palacos gentamicin for the treatment of deep periprosthetic hip infections. Clin Orthop Relat Res 298:97–105PubMed
5.
Zurück zum Zitat Garvin KL, Hanssen AD (1995) Infection after total hip arthroplasty. Past, present, and future. J Bone Joint Surg Am 77:1576–1588PubMed Garvin KL, Hanssen AD (1995) Infection after total hip arthroplasty. Past, present, and future. J Bone Joint Surg Am 77:1576–1588PubMed
6.
Zurück zum Zitat Haddad FS, Masri BA, Garbuz DS, Duncan CP (1999) The treatment of the infected hip replacement. The complex case. Clin Orthop Relat Res 369:144–156PubMedCrossRef Haddad FS, Masri BA, Garbuz DS, Duncan CP (1999) The treatment of the infected hip replacement. The complex case. Clin Orthop Relat Res 369:144–156PubMedCrossRef
7.
Zurück zum Zitat Haddad FS, Muirhead-Allwood SK, Manktelow AR, Bacarese-Hamilton I (2000) Two-stage uncemented revision hip arthroplasty for infection. J Bone Joint Surg Br 82:689–694PubMedCrossRef Haddad FS, Muirhead-Allwood SK, Manktelow AR, Bacarese-Hamilton I (2000) Two-stage uncemented revision hip arthroplasty for infection. J Bone Joint Surg Br 82:689–694PubMedCrossRef
8.
Zurück zum Zitat Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 51:737–755PubMed Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 51:737–755PubMed
9.
Zurück zum Zitat Hsieh PH, Shih CH, Chang YH, Lee MS, Yang WE, Shih HN (2005) Treatment of deep infection of the hip associated with massive bone loss: two-stage revision with an antibiotic-loaded interim cement prosthesis followed by reconstruction with allograft. J Bone Joint Surg Br 87:770–775PubMedCrossRef Hsieh PH, Shih CH, Chang YH, Lee MS, Yang WE, Shih HN (2005) Treatment of deep infection of the hip associated with massive bone loss: two-stage revision with an antibiotic-loaded interim cement prosthesis followed by reconstruction with allograft. J Bone Joint Surg Br 87:770–775PubMedCrossRef
10.
Zurück zum Zitat Jackson WO, Schmalzried TP (2000) Limited role of direct exchange arthroplasty in the treatment of infected total hip replacements. Clin Orthop Relat Res 381:101–105PubMedCrossRef Jackson WO, Schmalzried TP (2000) Limited role of direct exchange arthroplasty in the treatment of infected total hip replacements. Clin Orthop Relat Res 381:101–105PubMedCrossRef
11.
Zurück zum Zitat Joshi RP, Eftekhar NS, McMahon DJ, Nercessian OA (1998) Osteolysis after Charnley primary low-friction arthroplasty. A comparison of two matched paired groups. J Bone Joint Surg Br 80:585–590PubMedCrossRef Joshi RP, Eftekhar NS, McMahon DJ, Nercessian OA (1998) Osteolysis after Charnley primary low-friction arthroplasty. A comparison of two matched paired groups. J Bone Joint Surg Br 80:585–590PubMedCrossRef
12.
Zurück zum Zitat Kamme C, Lindberg L (1981) Aerobic and anaerobic bacteria in deep infections after total hip arthroplasty: differential diagnosis between infectious and non-infectious loosening. Clin Orthop Relat Res 154:201–207PubMed Kamme C, Lindberg L (1981) Aerobic and anaerobic bacteria in deep infections after total hip arthroplasty: differential diagnosis between infectious and non-infectious loosening. Clin Orthop Relat Res 154:201–207PubMed
13.
Zurück zum Zitat Koo KH, Yang JW, Cho SH, Song HR, Park HB, Ha YC, Chang JD, Kim SY, Kim YH (2001) Impregnation of vancomycin, gentamicin, and cefotaxime in a cement spacer for two-stage cementless reconstruction in infected total hip arthroplasty. J Arthroplasty 16:882–892PubMedCrossRef Koo KH, Yang JW, Cho SH, Song HR, Park HB, Ha YC, Chang JD, Kim SY, Kim YH (2001) Impregnation of vancomycin, gentamicin, and cefotaxime in a cement spacer for two-stage cementless reconstruction in infected total hip arthroplasty. J Arthroplasty 16:882–892PubMedCrossRef
14.
Zurück zum Zitat Lai KA, Shen WJ, Yang CY, Lin RM, Lin CJ, Jou IM (1996) Two-stage cementless revision THR after infection. 5 recurrences in 40 cases followed 2.5–7 years. Acta Orthop Scand 67:325–328PubMedCrossRef Lai KA, Shen WJ, Yang CY, Lin RM, Lin CJ, Jou IM (1996) Two-stage cementless revision THR after infection. 5 recurrences in 40 cases followed 2.5–7 years. Acta Orthop Scand 67:325–328PubMedCrossRef
15.
Zurück zum Zitat Laupacis A, Bourne R, Rorabeck C, Feeny D, Wong C, Tugwell P, Leslie K, Bullas R (1993) The effect of elective total hip replacement on health-related quality of life. J Bone Joint Surg Am 75:1619–1626PubMed Laupacis A, Bourne R, Rorabeck C, Feeny D, Wong C, Tugwell P, Leslie K, Bullas R (1993) The effect of elective total hip replacement on health-related quality of life. J Bone Joint Surg Am 75:1619–1626PubMed
16.
Zurück zum Zitat Loty B, Postel M, Evrard J, Matron P, Courpied JP, Kerboull M, Tomeno B (1992) One stage revision of infected total hip replacements with replacement of bone loss by allografts. Study of 90 cases of which 46 used bone allografts (in French). Int Orthop 16:330–338PubMedCrossRef Loty B, Postel M, Evrard J, Matron P, Courpied JP, Kerboull M, Tomeno B (1992) One stage revision of infected total hip replacements with replacement of bone loss by allografts. Study of 90 cases of which 46 used bone allografts (in French). Int Orthop 16:330–338PubMedCrossRef
17.
Zurück zum Zitat Maloney WJ, Jasty M, Harris WH, Galante JO, Callaghan JJ (1990) Endosteal erosion in association with stable uncemented femoral components. J Bone Joint Surg Am 72:1025–1034PubMed Maloney WJ, Jasty M, Harris WH, Galante JO, Callaghan JJ (1990) Endosteal erosion in association with stable uncemented femoral components. J Bone Joint Surg Am 72:1025–1034PubMed
18.
Zurück zum Zitat Masri BA, Panagiotopoulos KP, Greidanus NV, Garbuz DS, Duncan CP (2007) Cementless two-stage exchange arthroplasty for infection after total hip arthroplasty. J Arthroplasty 22:72–78PubMedCrossRef Masri BA, Panagiotopoulos KP, Greidanus NV, Garbuz DS, Duncan CP (2007) Cementless two-stage exchange arthroplasty for infection after total hip arthroplasty. J Arthroplasty 22:72–78PubMedCrossRef
19.
Zurück zum Zitat Mulroy WF, Harris WH (1996) Revision total hip arthroplasty with use of so-called second-generation cementing techniques for aseptic loosening of the femoral component. A fifteen-year-average follow-up study. J Bone Joint Surg Am 78:325–330PubMed Mulroy WF, Harris WH (1996) Revision total hip arthroplasty with use of so-called second-generation cementing techniques for aseptic loosening of the femoral component. A fifteen-year-average follow-up study. J Bone Joint Surg Am 78:325–330PubMed
20.
Zurück zum Zitat Raut VV, Orth MS, Orth MC, Siney PD, Wroblewski BM (1996) One stage revision arthroplasty of the hip for deep gram negative infection. Int Orthop 20:12–14PubMedCrossRef Raut VV, Orth MS, Orth MC, Siney PD, Wroblewski BM (1996) One stage revision arthroplasty of the hip for deep gram negative infection. Int Orthop 20:12–14PubMedCrossRef
21.
Zurück zum Zitat Raut VV, Siney PD, Wroblewski BM (1995) One-stage revision of total hip arthroplasty for deep infection. Long-term followup. Clin Orthop Relat Res 321:202–207PubMed Raut VV, Siney PD, Wroblewski BM (1995) One-stage revision of total hip arthroplasty for deep infection. Long-term followup. Clin Orthop Relat Res 321:202–207PubMed
22.
Zurück zum Zitat Sanzen L, Carlsson AS, Josefsson G, Lindberg LT (1988) Revision operations on infected total hip arthroplasties. Two- to nine-year follow-up study. Clin Orthop Relat Res 229:165–172PubMed Sanzen L, Carlsson AS, Josefsson G, Lindberg LT (1988) Revision operations on infected total hip arthroplasties. Two- to nine-year follow-up study. Clin Orthop Relat Res 229:165–172PubMed
23.
Zurück zum Zitat Schutzer SF, Harris WH (1988) Deep-wound infection after total hip replacement under contemporary aseptic conditions. J Bone Joint Surg Am 70:724–727PubMed Schutzer SF, Harris WH (1988) Deep-wound infection after total hip replacement under contemporary aseptic conditions. J Bone Joint Surg Am 70:724–727PubMed
24.
Zurück zum Zitat Ure KJ, Amstutz HC, Nasser S, Schmalzried TP (1998) Direct-exchange arthroplasty for the treatment of infection after total hip replacement. An average ten-year follow-up. J Bone Joint Surg Am 80:961–968PubMed Ure KJ, Amstutz HC, Nasser S, Schmalzried TP (1998) Direct-exchange arthroplasty for the treatment of infection after total hip replacement. An average ten-year follow-up. J Bone Joint Surg Am 80:961–968PubMed
Metadaten
Titel
One-stage cementless revision arthroplasty for infected hip replacements
verfasst von
Jeong Joon Yoo
Young Sam Kwon
Kyung-Hoi Koo
Kang Sup Yoon
Young-Min Kim
Hee Joong Kim
Publikationsdatum
01.10.2009
Verlag
Springer-Verlag
Erschienen in
International Orthopaedics / Ausgabe 5/2009
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-008-0640-x

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