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Study: Two-stage TJA exchange risk-benefit ratio may change for the worse
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Researchers recommended that the use of antibiotic spacers after two-stage exchange revision joint arthroplasty due to prosthetic joint infection be standardized after they identified a high incidence of complications and acute kidney injuries in patients who underwent the revisions, according to this study.
“In summary, published studies report an [acute kidney injury] AKI complication rate of 4.8% and infection failure rate of 11% yielding a favorable risk–benefit ratio,” Andrew Luu, MD, and colleagues wrote in their study. “However, under-recognized and/or under-reported rates of systemic complications and the expected increase in periprosthetic joint infections as a result of the increasing need for primary arthroplasties in an aging population raises concerns that this risk–benefit ratio might change.”
The researchers identified 10 studies with 544 patients between January 1989 and June 2012 that had a 4.8% average complication rate after a two-stage exchange, according to the abstract. Specifically, they found an 11% infection rate in follow-up that ranged from 13 months to 108 months.
Disclosures: Hadley is a consultant for Merck & Co. Inc. and Abbot Pharmaceuticals. Smith is a paid consultant for Omni Life Science and receives research support from Stryker.
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