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Two-stage hip revision arthroplasty with a hexagonal modular cementless stem in cases of periprosthetic infection

BACKGROUND: Two-stage revision arthroplasty is today regarded as the gold standard treatment method for deep prosthetic joint infection. The aim of the present study was to evaluate clinical and functional outcomes with the Modular Universal Tumor And Revision System (MUTARS) RS stem in patients und...

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Autores principales: Dieckmann, Ralf, Schulz, Dino, Gosheger, Georg, Becker, Karsten, Daniilidis, Kiriakos, Streitbürger, Arne, Hardes, Jendrik, Hoell, Steffen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4289174/
https://www.ncbi.nlm.nih.gov/pubmed/25428415
http://dx.doi.org/10.1186/1471-2474-15-398
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author Dieckmann, Ralf
Schulz, Dino
Gosheger, Georg
Becker, Karsten
Daniilidis, Kiriakos
Streitbürger, Arne
Hardes, Jendrik
Hoell, Steffen
author_facet Dieckmann, Ralf
Schulz, Dino
Gosheger, Georg
Becker, Karsten
Daniilidis, Kiriakos
Streitbürger, Arne
Hardes, Jendrik
Hoell, Steffen
author_sort Dieckmann, Ralf
collection PubMed
description BACKGROUND: Two-stage revision arthroplasty is today regarded as the gold standard treatment method for deep prosthetic joint infection. The aim of the present study was to evaluate clinical and functional outcomes with the Modular Universal Tumor And Revision System (MUTARS) RS stem in patients undergoing two-stage revisions. METHODS: The functional and clinical outcomes for 43 patients who had undergone two-stage revision procedures for PJI were analyzed in a retrospective study. The minimum follow-up period was 24 months. Shorter follow-up periods were only observed when there were complications such as loosening or recurrent infection. The mean follow-up period was 3.86 years (range 7 months to 11.6 years). RESULTS: The success rate with infection control for PJI was 93%. Reinfection occurred in four cases (7%). The risk of reinfection after MRSA infection was 20.5 times greater (P >0.01) than with sensitive or unknown bacteria. Two aseptic loosening occurred after 7 and 20 months. The average Harris Hip Score was 80 (range 62–93). CONCLUSION: This retrospective study showed a 93% rate of eradication using specific antibiotic therapy. With the modular MUTARS RS stem, there was a low rate of aseptic loosening of 4.6%. MRSA infection was identified as a risk factor for reinfection. The two-stage procedure with modular cementless implants used is therefore appropriate for treating periprosthetic infections associated with hip endoprostheses. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/1471-2474-15-398) contains supplementary material, which is available to authorized users.
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spelling pubmed-42891742015-01-11 Two-stage hip revision arthroplasty with a hexagonal modular cementless stem in cases of periprosthetic infection Dieckmann, Ralf Schulz, Dino Gosheger, Georg Becker, Karsten Daniilidis, Kiriakos Streitbürger, Arne Hardes, Jendrik Hoell, Steffen BMC Musculoskelet Disord Research Article BACKGROUND: Two-stage revision arthroplasty is today regarded as the gold standard treatment method for deep prosthetic joint infection. The aim of the present study was to evaluate clinical and functional outcomes with the Modular Universal Tumor And Revision System (MUTARS) RS stem in patients undergoing two-stage revisions. METHODS: The functional and clinical outcomes for 43 patients who had undergone two-stage revision procedures for PJI were analyzed in a retrospective study. The minimum follow-up period was 24 months. Shorter follow-up periods were only observed when there were complications such as loosening or recurrent infection. The mean follow-up period was 3.86 years (range 7 months to 11.6 years). RESULTS: The success rate with infection control for PJI was 93%. Reinfection occurred in four cases (7%). The risk of reinfection after MRSA infection was 20.5 times greater (P >0.01) than with sensitive or unknown bacteria. Two aseptic loosening occurred after 7 and 20 months. The average Harris Hip Score was 80 (range 62–93). CONCLUSION: This retrospective study showed a 93% rate of eradication using specific antibiotic therapy. With the modular MUTARS RS stem, there was a low rate of aseptic loosening of 4.6%. MRSA infection was identified as a risk factor for reinfection. The two-stage procedure with modular cementless implants used is therefore appropriate for treating periprosthetic infections associated with hip endoprostheses. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/1471-2474-15-398) contains supplementary material, which is available to authorized users. BioMed Central 2014-11-26 /pmc/articles/PMC4289174/ /pubmed/25428415 http://dx.doi.org/10.1186/1471-2474-15-398 Text en © Dieckmann et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Dieckmann, Ralf
Schulz, Dino
Gosheger, Georg
Becker, Karsten
Daniilidis, Kiriakos
Streitbürger, Arne
Hardes, Jendrik
Hoell, Steffen
Two-stage hip revision arthroplasty with a hexagonal modular cementless stem in cases of periprosthetic infection
title Two-stage hip revision arthroplasty with a hexagonal modular cementless stem in cases of periprosthetic infection
title_full Two-stage hip revision arthroplasty with a hexagonal modular cementless stem in cases of periprosthetic infection
title_fullStr Two-stage hip revision arthroplasty with a hexagonal modular cementless stem in cases of periprosthetic infection
title_full_unstemmed Two-stage hip revision arthroplasty with a hexagonal modular cementless stem in cases of periprosthetic infection
title_short Two-stage hip revision arthroplasty with a hexagonal modular cementless stem in cases of periprosthetic infection
title_sort two-stage hip revision arthroplasty with a hexagonal modular cementless stem in cases of periprosthetic infection
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4289174/
https://www.ncbi.nlm.nih.gov/pubmed/25428415
http://dx.doi.org/10.1186/1471-2474-15-398
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