Re-revision rates may be higher in 1.5-stage vs. two-stage revision for PJI after THA
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Key takeaways:
- A 1.5-stage revision had higher re-revision rates vs. two-stage revision for infection after total hip arthroplasty.
- Mortality rates were worse, but not statistically significant, in the 1.5-stage group.
Results presented at the Musculoskeletal Infection Society Annual Meeting showed 1.5-stage revision for periprosthetic joint infection after total hip arthroplasty may not be equivalent to two-stage revision.
“The 1.5-stage group had significantly more prior revisions and comorbidities [and] higher re-revision rate for PJI,” Carlos A. Higuera Rueda, MD, chair of the Levitetz department of orthopaedic surgery at Cleveland Clinic Florida’s Weston Hospital, said in his presentation. “This has to be discussed with the patient.”
Higuera Rueda and colleagues retrospectively analyzed data from 73 patients who underwent revision THA for PJI from 2019 to 2023. Outcomes measured included patient-reported outcomes, operative details, adverse outcomes and re-revision rates.
According to Higuera Rueda, operative time was shorter in the 1.5-stage revision group vs. the two-stage revision group. He said there were no differences in length of stay, transfusions and the proportion of causative organisms.
However, patients in the 1.5-stage group had significantly increased re-revision rates and more radiographic loosening vs. the two-stage group. In addition, while not statistically significant, rates of mortality and Musculoskeletal Infection Society success criteria were worse in the 1.5-stage group vs. the two-stage group, according to Higuera Rueda.
“The role of 1.5-stage revision for total hip should be limited in this type of high-risk patients,” Higuera Rueda concluded.
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Higuera Rueda CA, et al. Paper 1247. Presented at: Musculoskeletal Infection Society Annual Meeting; Aug. 2-3, 2024; Durham, North Carolina (hybrid meeting).
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