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Managing early complications in total hip arthroplasty: the safety of immediate revision

PURPOSE: Immediate revision refers to a reoperation that involves resetting, draping, and exchanging the implant, after wound closure in total hip arthroplasty. The purpose of this study is to investigate the impact of immediate revision after total hip arthroplasty on subsequent infection and compl...

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Autores principales: Descamps, Jules, Teissier, Victoria, Graff, Wilfrid, Mouton, Antoine, Bouché, Pierre-Alban, Marmor, Simon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10390444/
https://www.ncbi.nlm.nih.gov/pubmed/37525070
http://dx.doi.org/10.1186/s10195-023-00719-1
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author Descamps, Jules
Teissier, Victoria
Graff, Wilfrid
Mouton, Antoine
Bouché, Pierre-Alban
Marmor, Simon
author_facet Descamps, Jules
Teissier, Victoria
Graff, Wilfrid
Mouton, Antoine
Bouché, Pierre-Alban
Marmor, Simon
author_sort Descamps, Jules
collection PubMed
description PURPOSE: Immediate revision refers to a reoperation that involves resetting, draping, and exchanging the implant, after wound closure in total hip arthroplasty. The purpose of this study is to investigate the impact of immediate revision after total hip arthroplasty on subsequent infection and complication rates. METHODS: A total of 14,076 primary total hip arthroplasties performed between 2010 and 2020 were identified in our institutional database, of which 42 underwent immediate revision. Infection rates were determined 2 years after the index arthroplasty. The cause and type of revision, duration of primary and revision surgeries, National Nosocomial Infections Surveillance score, implant type, changes in implants, complications, and preoperative and intraoperative antibiotic prophylaxis were all determined. RESULTS: No infections were observed within 2 years after the index arthroplasty. Leg length discrepancy (88%, n = 37) and dislocation (7.1%, n = 3) were the main causes of immediate revision. In most cases of discrepancy, the limb was clinically and radiologically longer before the immediate revision. The mean operative time was 48 ± 14 min for the primary procedure and 23.6 ± 9 min for the revision. The time between the first incision and last skin closure ranged from 1 to 3 h. None of the patients were extubated between the two procedures. Two patients had a National Nosocomial Infections Surveillance score of 2, 13 had a score of 1, and 27 had a score of 0. CONCLUSION: Immediate revision is safe for correcting clinical and radiological abnormalities, and may not be associated with increased complication or infection rates. STUDY DESIGN: Retrospective cohort study; level of evidence, 3.
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spelling pubmed-103904442023-08-02 Managing early complications in total hip arthroplasty: the safety of immediate revision Descamps, Jules Teissier, Victoria Graff, Wilfrid Mouton, Antoine Bouché, Pierre-Alban Marmor, Simon J Orthop Traumatol Original Article PURPOSE: Immediate revision refers to a reoperation that involves resetting, draping, and exchanging the implant, after wound closure in total hip arthroplasty. The purpose of this study is to investigate the impact of immediate revision after total hip arthroplasty on subsequent infection and complication rates. METHODS: A total of 14,076 primary total hip arthroplasties performed between 2010 and 2020 were identified in our institutional database, of which 42 underwent immediate revision. Infection rates were determined 2 years after the index arthroplasty. The cause and type of revision, duration of primary and revision surgeries, National Nosocomial Infections Surveillance score, implant type, changes in implants, complications, and preoperative and intraoperative antibiotic prophylaxis were all determined. RESULTS: No infections were observed within 2 years after the index arthroplasty. Leg length discrepancy (88%, n = 37) and dislocation (7.1%, n = 3) were the main causes of immediate revision. In most cases of discrepancy, the limb was clinically and radiologically longer before the immediate revision. The mean operative time was 48 ± 14 min for the primary procedure and 23.6 ± 9 min for the revision. The time between the first incision and last skin closure ranged from 1 to 3 h. None of the patients were extubated between the two procedures. Two patients had a National Nosocomial Infections Surveillance score of 2, 13 had a score of 1, and 27 had a score of 0. CONCLUSION: Immediate revision is safe for correcting clinical and radiological abnormalities, and may not be associated with increased complication or infection rates. STUDY DESIGN: Retrospective cohort study; level of evidence, 3. Springer International Publishing 2023-07-31 2023-12 /pmc/articles/PMC10390444/ /pubmed/37525070 http://dx.doi.org/10.1186/s10195-023-00719-1 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Descamps, Jules
Teissier, Victoria
Graff, Wilfrid
Mouton, Antoine
Bouché, Pierre-Alban
Marmor, Simon
Managing early complications in total hip arthroplasty: the safety of immediate revision
title Managing early complications in total hip arthroplasty: the safety of immediate revision
title_full Managing early complications in total hip arthroplasty: the safety of immediate revision
title_fullStr Managing early complications in total hip arthroplasty: the safety of immediate revision
title_full_unstemmed Managing early complications in total hip arthroplasty: the safety of immediate revision
title_short Managing early complications in total hip arthroplasty: the safety of immediate revision
title_sort managing early complications in total hip arthroplasty: the safety of immediate revision
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10390444/
https://www.ncbi.nlm.nih.gov/pubmed/37525070
http://dx.doi.org/10.1186/s10195-023-00719-1
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