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Risk factors for failed two-stage procedure after chronic posttraumatic periprosthetic hip infections

  • Hip Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The aim of the study was to identify risk factors of failed two-stage procedures in cases of chronic posttraumatic periprosthetic hip infections.

Patients and methods

Between 2006 and 2008, 26 patients with chronic posttraumatic periprosthetic infections after hip arthroplasty were included. In all cases operative bacterial eradication was initiated. The therapy was carried out according to a standardized treatment protocol including the eradication of the bacterial infection and the prosthetic replacement after three negative intra-operative specimens as a two-stage procedure. Follow-up was performed at least 2 years after revision procedure.

Results

Twelve patients showed no signs of infectious recurrence 2 years after prosthetic hip revision therapy (46 %) and were assigned to group I. Group II is constituted by the other 14 patients (54 %). Four of them (16 %) suffered from an infectious recurrence after prosthetic hip replacement, ten patients (38 %) were characterised by a failed bacterial eradication. The spectrum of pathogens showed a significantly higher resistance pattern (p = 0.001) in group II, with a majority of methicillin-resistant Staphylococcus epidermidis (MRSE) and highly resistant Pseudomonas. In addition, patients of group II offered significantly higher American Society of Anesthesiology (ASA) scores (p = 0.015), the body mass index (BMI) was significantly elevated (p = 0.031) and received a significantly higher number of operative procedures (p = 0.016).

Conclusions

A reduced general state of health, a high BMI and highly resistant pathogens are the main risk factors for a failed two-stage procedure after chronic posttraumatic periprosthetic hip infections. Therefore, different treatment strategies are required for a defined subgroup of patients.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Berufsgenossenschaftliche Unfallklinik, Trauma center Murnau, Prof.-Küntscher-Str. 8, 82418, Murnau, Germany

    Ulrich Spiegl, Jan Friederichs, Robert Pätzold, Matthias Militz & Volker Bühren

  2. Department of Trauma and Reconstructive Surgery, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany

    Ulrich Spiegl & Christoph Josten

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  1. Ulrich Spiegl
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  2. Jan Friederichs
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  3. Robert Pätzold
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  6. Volker Bühren
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Correspondence to Ulrich Spiegl.

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Spiegl, U., Friederichs, J., Pätzold, R. et al. Risk factors for failed two-stage procedure after chronic posttraumatic periprosthetic hip infections. Arch Orthop Trauma Surg 133, 421–428 (2013). https://doi.org/10.1007/s00402-012-1673-6

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  • DOI: https://doi.org/10.1007/s00402-012-1673-6

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