Skip to main content
SpringerLink
Log in

Functional and Emotional Results Differ After Aseptic vs Septic Revision Hip Arthroplasty

  • Original Article
  • Published:
HSS Journal ®

Abstract

Background

It is widely believed that a deep implant infection leads to poor functional and emotional outcomes following total hip arthroplasty.

Questions/Purpose

The purpose of this retrospective comparative review was to determine if patients who undergo two-stage, septic revision hip arthroplasty will have decreased emotional and general health scores, in addition to decreased function, compared to the aseptic revision group.

Patients and Methods

One hundred forty-five of 195 patients who underwent aseptic total hip revision for aseptic loosening (mean follow-up = 61 months) and 45 of 73 patients who underwent two-stage, septic revision hip arthroplasty (mean follow-up = 48 months) met the inclusion criteria and had a technically successful outcome. All patients were retrospectively evaluated using Harris Hip Scores (HHS), ad hoc questions, and the SF-36 Health Survey.

Results

The average HHS were 73.2 ± 20.5 (aseptic) and 57.4 ± 20.6 (septic). Significant differences in the SF-36 Health Survey were found between the two groups in: physical functioning (p = 0.026) and role limitations due to physical health (p = 0.004). No significant difference in SF-36 scores was seen in: Energy/Fatigue, General Health Perception, Personal or Emotional Problems, Role Limitations due to Emotional Well Being, Social Functioning, and Bodily Pain.

Conclusions

Two-stage, septic revision produces a poor functional outcome compared to aseptic revision; however, the overall impact of a septic revision emotionally and socially was not significantly different than patients undergoing aseptic revision.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Barrack RL, Engh G, Rorabeck C, Sawhney J, Woolfrey M. Patient Satisfaction and outcome after septic versus aseptic revision total knee arthroplasty. J Arthroplasty. 2000;15:990–993.

    Article  CAS  Google Scholar 

  2. Bozic KJ, Kurtz SM, Lau E, Ong K, Vail TP, Berry DJ. The epidemiology of revision total hip arthroplasty in the United States. J Bone Joint Surg Am. 2009;91:128–133.

    Article  Google Scholar 

  3. Gallo J, Rozkydal Z, Sklensky M. Reconstruction of severe acetabular bone defects using Burch-Schneider cage. Acta Chir Orthop Traumatol Cech. 2006;73:157–163.

    CAS  PubMed  Google Scholar 

  4. Hozack WJ. Rothman RH, Albert TJ, Balderston RA, Eng K. Relationship of total hip arthroplasty outcome to other orthopaedic procedures. Clin Orthop Relat Res. 1997;344:88–93.

    Article  Google Scholar 

  5. Ito H, Matsuno T, Aok Y, Minami A. Total hip arthroplasty using an omniflex modular system: 5 to 12 years follow-up. Clin Orthop Relat Res. 2004; 419: 98–106.

    Article  Google Scholar 

  6. Korovessis P, Repantis T. High Medium-term Survival of Zweymuller SLR-Plus((R)) Stem Used in Femoral Revision. Clin Orthop Relat Res. 2009;467:2032–2040.

    Article  Google Scholar 

  7. Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005–2030. J Bone Joint Surg Am. 2007;89:780–785.

    PubMed  Google Scholar 

  8. Lai KA, Shen WJ, Yang CY, Lin RM, Lin CJ, Jou IM. Two-stage cementless revision THR after infection. 5 recurrences in 40 cases followed 2.5 – 7 years. Acta Orthop Scand 1996; 67:325–328.

    Article  CAS  Google Scholar 

  9. Ochs BG, Volkmann R, Eingartner C, Ludolph I, Weller S, Weise K, Ochs U. Treatment of large femoral bone defects--15-year experiences with the cementless Bicontact revision stem with distal interlocking. Z Orthop Unfall. 2007; 145(Suppl 1):S34–S39.

    Article  Google Scholar 

  10. Ong KL, Mowat FS, Chan N, Lau E, Halpern MT, Kurtz SM. Economic burden of revision hip and knee arthroplasty in Medicare enrollees. Clin Orthop Relat Res. 2006;446:22–28.

    Article  CAS  Google Scholar 

  11. Ornstein E, Linder L, Ranstam J, Lewold S, Eisler T, Torper M. Femoral Impaction bone grafting with the Exeter stem - the Swedish experience: survivorship analysis of 1305 revisions performed between 1989 and 2002. J Bone Joint Surg Br. 2009;91:441–446.

    Article  CAS  Google Scholar 

  12. Park KS, Yoon TR, Song EK, Lee KB. Cementless Acetabular Socket Revisions Using Metasul Metal-on-Metal Bearings. J Arthroplasty. 2010;25:533–537.

    Article  CAS  Google Scholar 

  13. Parratte S, Argenson JN, Flecher X, Aubaniac JM. Acetabular revision for aseptic loosening in total hip arthroplasty using cementless cup and impacted morselized allograft. Rev Chir Orthop Reparatrice Appar Mot. 2007; 93:255–263.

    Article  CAS  Google Scholar 

  14. Romano CL, Romano D, Logoluso N, Meani E. Septic versus aseptic hip revision: how different? J Orthop Traumatol. 2010;11:167–174.

    Article  Google Scholar 

  15. Schlegel UJ, Bitsch RG, Pritsch M, Aldinger PR, Mau H, Breusch SJ. Acetabular reinforcement rings in revision total hip arthroplasty: midterm results in 298 cases. Orthopade. 2008;37:904, 906–913.

    Google Scholar 

  16. Schlegel UJ, Bitsch RG, Pritsch M, Clauss M, Mau H, Breusch SJ. Mueller reinforcement rings in acetabular revision: outcome in 164 hips followed for 2–17 years. Acta Orthop. 2006;77:234–241.

    Article  Google Scholar 

  17. Stedry V, Dungl P, Hajny P. Revision of total hip replacement operations at the Orthoedic Clinic IPVZ in Prague, 1999. Acta Chir Orthop Traumatol Cech. 2001;68:18–23.

    CAS  PubMed  Google Scholar 

  18. Tamvakopoulos GS, Servant CT, Clark G, Ivory JP. Medium-term follow-up series using a modular distal fixation prosthesis to address proximal femoral bone deficiency in revision total hip arthroplasty. A 5–9 year follow-up study. Hip Int. 2007;17:143–149.

    Article  CAS  Google Scholar 

  19. Tarasevicius S, Zegunis V, Tarasevicius R, Kalesinskas RJ, Janusonis V. Hip revision arthroplasty (long-term results). Medicina (Kaunas). 2004;40:332–337.

    Google Scholar 

  20. Tulic G, Dulic B, Vucetic C, Todorovic A. Our first experience with extended proximal femoral osteotomy for revision hip surgery. Hip Int. 2007;17:224–229.

    Article  CAS  Google Scholar 

  21. Wang CJ, Hsieh MC, Huang TW, Wang JW, Chen HS, Liu CY. Clinical outcome and patient satisfaction in aseptic and septic revision total knee arthroplasty. Knee. 2004;11:45–49.

    Article  Google Scholar 

  22. Weeden SH, Schmidt RH. The use of tantalum porous metal implants for Paprosky 3A and 3B defects. J Arthroplasty. 2007;22(6 Suppl 2):151–155.

    Article  Google Scholar 

  23. Wu LD, Xiong Y, Yan SG, Yang QS, Dai XS. Femoral Component Revision using extensively porous-coated cementless stem. Chin J Traumatol. 2005; 8:358–63.

    PubMed  Google Scholar 

Download references

Acknowledgments

This study was partially funded by the Eduardo Salvati Resident Research Grant (MBC).

Author information

Authors and Affiliations

  1. Department of Orthopaedics, Münster University Hospital, Münster, Germany

    Tobias Kluthe BS, Miriam Schulte BS & Christian Goetze MD

  2. Hospital for Special Surgery, 535 E 70th St, New York, NY, 10021, USA

    Friedrich Boettner MD, Michael B. Cross MD & Denis Nam MD

Authors
  1. Friedrich Boettner MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michael B. Cross MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Denis Nam MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tobias Kluthe BS
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Miriam Schulte BS
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Christian Goetze MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Friedrich Boettner MD.

Additional information

Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution has approved the reporting of these cases, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participating in the study was obtained.

This work was performed at the Münster University Hospital.

Level of evidence: Level III therapeutic study. See levels of evidence for a complete description.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Boettner, F., Cross, M.B., Nam, D. et al. Functional and Emotional Results Differ After Aseptic vs Septic Revision Hip Arthroplasty. HSS Jrnl 7, 235–238 (2011). https://doi.org/10.1007/s11420-011-9211-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11420-011-9211-6

Keywords

Search

Navigation