Two-stage revision THA associated with good survivorship rates, positive outcomes for PJI
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Key takeaways:
- Two-stage revision total hip arthroplasty yielded good survivorship rates and patient-reported outcomes at midterm to long-term follow-up.
- Minimum 2-year infection-free survivorship was 73.8%.
Patients who underwent two-stage revision total hip arthroplasty for periprosthetic joint infection had a minimum 2-year infection-free survivorship of 73.8% and improved patient-reported outcomes at midterm to long-term follow-up.
Researchers performed a retrospective chart review of 328 patients (mean age, 67 years) who underwent two-stage revision THA for PJI between April 1, 1999, and April 30, 2020. They assessed survivorship, reoperations and patient-reported outcome measures (PROMs) at a median follow-up of 7 years.
Overall, researchers found a 73.8% survivorship free of infection at a minimum of 2 years and a statistically significant improvement in all PROMs from preoperative measures to latest follow-up after two-stage revision THA. They noted 59.1% of patients (n = 194) who had successful infection eradication underwent two-stage revision only.
According to the study, the most common infections were Staphylococcus aureus (12.5%) and Staphylococcus epidermidis (11%). Researchers noted patients with MRSA and polymicrobial infections had the highest reoperation rates.
“Two-stage revision THA is associated with a reasonably good success rate in the treatment of PJIs at mid[term] to long-term follow-up, with a nearly 80% success rate,” the researchers wrote in the study. “There, however, is variability in the literature as to how treatment success is defined.”
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