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

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.

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Acknowledgments

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

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Correspondence to Friedrich Boettner MD.

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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.

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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

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Keywords

  • septic
  • aseptic
  • revision
  • outcomes
  • hip arthroplasty