Longer time to reimplantation after prosthetic joint infection may yield worse outcomes
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Patients with a longer time to reimplantation after two-stage resection arthroplasty for prosthetic joint infection may experience worse overall outcomes, according to results.
Researchers categorized 101 patients undergoing resection arthroplasty with an antibiotic spacer for prosthetic joint infection into groups based on time from explantation and spacer placement to reimplantation. Time to reimplantation groups included less than 12 weeks, 12 to 18 weeks and greater than 18 weeks. Researchers obtained baseline patient and treatment course characteristics and used multivariate binary logistic regression to characterize association between treatment failure and time to reimplantation, controlling for American Society of Anesthesiologists (ASA) score and prior revision surgery.
Researchers noted the time to reimplantation groups had similar demographics except for ASA score. After controlling for ASA score and prior revision surgery, results showed patients with time to reimplantation of more than 18 weeks had statistically significant increased odds of treatment failure. Researchers found these increased odds of failure remained after excluding patients who required a second spacer or girdlestone prior to replant. At least one unplanned readmission between antibiotic spacer placement and replant occurred in 47.8% of patients with a time to reimplantation of more than 18 weeks compared with 18.6% of patients with a time to reimplantation from 12 to 18 weeks and 6.1% of patients with a time to reimplantation less than 12 weeks, according to results.
“Larger studies with larger patient cohorts spread across multiple medical centers are likely necessary to elucidate the most appropriate time for reimplantation in patients with specific comorbidities or surgical characteristics,” the authors wrote.
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