gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie
74. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie
96. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie
51. Tagung des Berufsverbandes der Fachärzte für Orthopädie und Unfallchirurgie

26. - 29.10.2010, Berlin

Analysis and results of 282 one stage exchange procedures for periprosthetic infection of the hip and knee

Meeting Abstract

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  • J. Wodtke - ENDO Klinik Hamburg, Chirurgie, Hamburg, Germany
  • V. Jonen - ENDO Klinik Hamburg, Chirurgie, Hamburg, Germany
  • D. Briem - ENDO Klinik Hamburg, Chirurgie, Hamburg, Germany

Deutscher Kongress für Orthopädie und Unfallchirurgie. 74. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 96. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 51. Tagung des Berufsverbandes der Fachärzte für Orthopädie. Berlin, 26.-29.10.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocIN21-1111

DOI: 10.3205/10dkou129, URN: urn:nbn:de:0183-10dkou1290

Veröffentlicht: 21. Oktober 2010

© 2010 Wodtke et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Objective: One and two stage exchange procedures are acknowledged as gold standard for revision surgery in periprosthetic infection. The one stage concept seems to offer considerable benefits, especially with regard to “quality of life in surgery” and economical aspects. However, it is still controversially discussed, which of both procedures provides better success rates. Aim of this study was to evaluate mid-term results of the one stage procedure.

Methods: Patients from a consecutive series of a three year period with one stage exchange for periprosthetic hip or knee infection were included in a retrospective study. Data regarding case history, microorganic spectrum, topic and systemic antibiotic treatment, surgical procedure, complication and success rate were recorded. Treatment success was defined as one stage exchange without any further revision due to recurrent infection. At the time of follow-up, patients were examined clinically and with a detailed protocol. Daily life activities and the patient’s contentedness and quality of life were assessed by the patient’s own rating.

Results and conclusions: During a three year period, 282 patients with an average age of 68.4±9.1 years (range 22–91) underwent one stage exchange for periprosthetic hip or knee infection at our institution. The study population consisted of 180 patients with hip and 102 patients with knee infection. Follow up was obtained after 31.8±4.3 months (range 15–51). 10 patients whose hips and knees worked well had died. None of them showed signs of infection until death. 21 patients were lost to follow-up. Overall, 19 patients had to be revised for recurrent infection. Thus, success rate of the one stage procedure was 92.7% in this study. Patients with hip infection revealed better results than patients with periprosthetic knee infection (96.5% vs. 89.9% success rate, p<0.05). 93% of all patients reported to be “very satisfied” or “satisfied” with the one stage procedure and presented with regular daily life activities.

Our study indicates, that the success rate of the one stage exchange for periprosthetic hip and knee joint infection is excellent. Compared to data from the literature, the one stage concept seems to be at least as successful as the competing two stage exchange. Further, the possibility of immediate mobilization without implant-free interval and the reduced costs represent crucial benefits of the one stage procedure. The one stage exchange can be recommended as the standard procedure for most of the patients with periprosthetic hip and knee infection.