Article
Revision surgery for periprosthetic joint infection: success rates from a District General Hospital in the UK
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Authors
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George Kleftouris
- Leeds, United Kingdom
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Simon Jones
- The Mid Yorkshire Hospitals NHS Trust, Wakefield, United Kingdom
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Aaron Ng
- The Mid Yorkshire Hospitals NHS Trust, Wakefield, United Kingdom
| Published: | October 26, 2021 |
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Outline
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Objectives: Periprosthetic joint infection (PJI) remains a challenging complication following hip and knee arthroplasty surgery. The aim of this study was to report on the outcomes of periprosthetic joint infections treated in a District General Hospital.
Methods: Between January 2015 and December 2018, all patients treated for periprosthetic joint infection in our institution were included retrospectively in the study. Periprosthetic joint infection was defined according to the criteria set by the Musculoskeletal Infection Society. The primary outcome of the study was to report on the 1-year infection free rate of this cohort. Secondary parameters included patient demographics, timing of infection since the index procedure, length of antibiotic course, operating surgeon, and the pathogen isolated.
Results and Conclusion: Forty-seven patients met the inclusion criteria. The overall 1-year infection free rate was 80% (37/46 patients). Thirteen patients had debridement, antibiotics and implant retention; 8/13 (61.5%) patients were free of infection at 1 year. Six patients had single stage revision; all of them were infection-free at one year (100%). Twenty-seven patients had 2-stage revision; 23/27 (85.2%) were infection-free at 1 year. The median time of developing PJI following total hip replacement and total knee replacement was 25.3 months. Twelve of the 33 patients (36.4%) who had either a single or a 2-stage revision had low grade infection. There was no association between 1-year re-infection and operating surgeon or the isolated pathogen.
Overall, periprosthetic joint infections can be treated successfully in a General District Hospital. Re-infection rates in our institution were comparable to rates reported in literature. Single stage revision can lead to excellent results; careful patient selection and a dedicated multidiscipline team are prerequisites for good clinical outcomes. Even following a two-stage approach, periprosthetic joint infections can be a challenging condition to treat.
