What Factors Cause Hip Reimplantation to Fail after a Two-Stage Revision Hip Arthroplasty?

  • Gonzalo García-Barreiro Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0002-2729-3961
  • Pablo Slullitel Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina http://orcid.org/0000-0002-8957-075X
  • José Oñativia Sanatorio del Norte, San Miguel de Tucumán, Tucumán, Argentina https://orcid.org/0000-0001-8534-5101
  • Gerardo Zanotti Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0001-8090-4832
  • Fernando Comba Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0002-2848-2983
  • Francisco Piccaluga Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0002-9887-4886
  • Martín Buttaro Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0003-3329-778X
DOI: https://doi.org/10.15417/issn.1852-7434.2021.86.4.1325
Keywords: Periprosthetic joint infection, total hip replacement, two-stage revision surgery

Abstract

Background: We analyzed the survivorship free-from-septic failure in a series of THA cases treated with a two-stage protocol at long-term follow-up, with a special focus on the relevance of positive frozen section and positive intraoperative culture taken during the reimplantation. Methods: We retrospectively reviewed data from 96 cases who met the Musculoskeletal Infection Society criteria for periprosthetic joint infection and who had undergone both stages of a two-stage protocol at our institution between 2008-2013. Mean follow-up was 90 months. Treatment failure was determined with a modified Delphi-based consensus definition. Kaplan-Meier estimate was used to determine survivorship free-from-septic failure. Log-Rank test was used to compare variables associated with septic failure. Results: Survival free-from-septic failure was 82.65% at 2 years (95%CI 73.25%-88.99%), 80.40% at 5 years (95%CI 70.70%-87.17%) and 77.32% at 6-10 years (95%CI 66.90%-84.33%). Patients with a positive culture at reimplantation had significantly more septic failures than those without it (Log-Rank test, p=0.0208), while patients with a positive frozen section at reimplantation had significantly more septic failures than those without it (Log-Rank test, p=0.0154). Conclusions: Reimplantations that remained at least 6 years without septic recurrences had a very low risk of further septic failure. Both positive frozen section and intraoperative culture at reimplantation were risk factors for septic failure.

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Author Biographies

Gonzalo García-Barreiro, Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”,Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Pablo Slullitel, Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”,Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
José Oñativia, Sanatorio del Norte, San Miguel de Tucumán, Tucumán, Argentina
Sanatorio del Norte, San Miguel de Tucumán, Tucumán, Argentina
Gerardo Zanotti, Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Fernando Comba, Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Francisco Piccaluga, Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”,Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Martín Buttaro, Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr. Carlos E. Ottolenghi”,Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

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Published
2021-08-19
How to Cite
García-Barreiro, G., Slullitel, P., Oñativia, J., Zanotti, G., Comba, F., Piccaluga, F., & Buttaro, M. (2021). What Factors Cause Hip Reimplantation to Fail after a Two-Stage Revision Hip Arthroplasty?. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 86(4), 501-511. https://doi.org/10.15417/issn.1852-7434.2021.86.4.1325
Issue
Vol 86 No 4 (2021)
Section
Clinical Research
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