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Partial two-stage exchange for infected total hip arthroplasty: An updated report

Journal of Arthroplasty Jul 12, 2019

Crawford DA, et al. - Through a retrospective review of researchers practice’s arthroplasty registry from 2000 to 2018 of 41 hips with a 2-year minimum follow-up that were treated with a two-stage partial exchange for an infected total hip arthroplasty, the researchers updated the previous records of treatment of periprosthetic infection (a devastating complication) of the hip with a partial two-stage exchange with retention of the femoral component. The mean follow-up was 5.5 years. At a mean interval of 9.2 weeks, the second stage reimplantation was succeeded in 39 of the 41 hips. For a persistent clinical sign of infection, 2 subjects underwent repeated radical debridement with the removal of all components before the reimplantation. At most recent follow-up, 33/41 hips (81%) were independent of infection. At the most recent assessment, the mean postoperative Harris hip score was calculated as 63.6. Hence, elimination of periprosthetic joint infections, while minimizing patient morbidity, remained to be a challenge. Moreover, in situations where removal of a well-fixed femoral component could lead to notable bony destruction, the partial two-stage exchange could be acknowledged.
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