Modular cemented stems may be a viable option for one-stage septic revision THA
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Key takeaways:
- Modular cemented stems were associated with excellent survival rates for one-stage revision THA for periprosthetic joint infection with bone loss.
- However, researchers cautioned about high complication rates.
Results showed the use of modular cemented stems for one-stage revision total hip arthroplasty in patients with periprosthetic infections and femoral bone loss was associated with excellent survival but high complication rates.
Researchers performed a retrospective single-center analysis of data from 150 patients (mean age of 68 years) who received a modular cemented stem during one-stage septic revision THA (rTHA) for a periprosthetic hip infection with massive femoral bone loss.
According to the study, outcome measures included complication, reinfection, reoperation and survivorship rates at a mean follow-up of 105 months.
Overall, 28 patients (18.7%) failed treatment and 42 patients (28%) had at least one reoperation at the latest follow-up. Researchers found 11 patients (7.3%) had reinfection, 10 patients (6.7%) had aseptic loosening of the acetabular component and two patients (1.3%) had aseptic loosening of the cemented stem. In addition, three patients (2%) required revision for a dislocation and two patients (1.3%) required revision for a periprosthetic fracture. Researchers noted prior surgery was associated with a lower success rate.
“The use of modular cemented stems is a viable option in case of septic one-stage rTHA associated with severe femoral bone loss,” the researchers wrote in the study. “However, surgeons and patients should be aware that this treatment is still characterized by a high rate of complications, which may lead to further surgeries,” they added.
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