55-283
Infección protésica de cadera. Recambio en dos tiempos en una serie de 50 casos.
Prosthetic hip infection. Two-stage revision in a series of 50 cases
Sánchez-Losilla C, Diranzo-García J, Estrems-Díaz V, Jara-García F, BruPomer A, Hernández-Ferrando L. SERVICIO DE CIRUGÍA ORTOPÉDICA Y TRAUMATOLOGÍA. HOSPITAL GENERAL UNIVERSITARIO DE VALENCIA
Recepción:
20/01/2021
Aceptación:
20/01/2021
Publicación:
20/01/2021
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Resumen (ES)
Chronic infection in hip replacement is an important complication with a complex treatment, that is solved by adequate
antibiotic therapy together with single-stage exchange or two-stage exchange. We present a descriptive and retrospective
study of a series of 50 consecutive patients operated on in our center with a diagnosis of chronic infection of the hip
prosthesis between 2007 and 2018 with a two-stage exchange. At a mean follow-up of 52 months, the overall implant
survival was 89%, with a 91% infection cure rate. The most frequent microorganism isolated was Staphylococcus
epidermidis. The mean score achieved on the HHS was 82,4 points and 1.67 points on the visual analogue scale. We
obtained better functional results (p=0,021) in those patients who had a preformed antibiotic-loaded spacer in the first
surgical stage. As complications, we recorded four cases of prosthetic reinfection (8,7%), three cases of dislocation
(6,5%), and one case of postsurgical hematoma (4,6%). No case of neurovascular injury or component loosening was
recorded. According to the showed results, we consider that two-stage revision procedure, although it is a demanding
surgery, is an effective method for the treatment of periprosthetic hip infection, with high implant survival and erradication
of the infection
antibiotic therapy together with single-stage exchange or two-stage exchange. We present a descriptive and retrospective
study of a series of 50 consecutive patients operated on in our center with a diagnosis of chronic infection of the hip
prosthesis between 2007 and 2018 with a two-stage exchange. At a mean follow-up of 52 months, the overall implant
survival was 89%, with a 91% infection cure rate. The most frequent microorganism isolated was Staphylococcus
epidermidis. The mean score achieved on the HHS was 82,4 points and 1.67 points on the visual analogue scale. We
obtained better functional results (p=0,021) in those patients who had a preformed antibiotic-loaded spacer in the first
surgical stage. As complications, we recorded four cases of prosthetic reinfection (8,7%), three cases of dislocation
(6,5%), and one case of postsurgical hematoma (4,6%). No case of neurovascular injury or component loosening was
recorded. According to the showed results, we consider that two-stage revision procedure, although it is a demanding
surgery, is an effective method for the treatment of periprosthetic hip infection, with high implant survival and erradication
of the infection
Palabras clave (ES):
tiempos
espaciador.
dos
en
recambio
infección
cadera
de
artroplastia
Resumen (EN)
Chronic infection in hip replacement is an important complication with a complex treatment, that is solved by adequate
antibiotic therapy together with single-stage exchange or two-stage exchange. We present a descriptive and retrospective
study of a series of 50 consecutive patients operated on in our center with a diagnosis of chronic infection of the hip
prosthesis between 2007 and 2018 with a two-stage exchange. At a mean follow-up of 52 months, the overall implant
survival was 89%, with a 91% infection cure rate. The most frequent microorganism isolated was Staphylococcus
epidermidis. The mean score achieved on the HHS was 82,4 points and 1.67 points on the visual analogue scale. We
obtained better functional results (p=0,021) in those patients who had a preformed antibiotic-loaded spacer in the first
surgical stage. As complications, we recorded four cases of prosthetic reinfection (8,7%), three cases of dislocation
(6,5%), and one case of postsurgical hematoma (4,6%). No case of neurovascular injury or component loosening was
recorded. According to the showed results, we consider that two-stage revision procedure, although it is a demanding
surgery, is an effective method for the treatment of periprosthetic hip infection, with high implant survival and erradication
of the infection
antibiotic therapy together with single-stage exchange or two-stage exchange. We present a descriptive and retrospective
study of a series of 50 consecutive patients operated on in our center with a diagnosis of chronic infection of the hip
prosthesis between 2007 and 2018 with a two-stage exchange. At a mean follow-up of 52 months, the overall implant
survival was 89%, with a 91% infection cure rate. The most frequent microorganism isolated was Staphylococcus
epidermidis. The mean score achieved on the HHS was 82,4 points and 1.67 points on the visual analogue scale. We
obtained better functional results (p=0,021) in those patients who had a preformed antibiotic-loaded spacer in the first
surgical stage. As complications, we recorded four cases of prosthetic reinfection (8,7%), three cases of dislocation
(6,5%), and one case of postsurgical hematoma (4,6%). No case of neurovascular injury or component loosening was
recorded. According to the showed results, we consider that two-stage revision procedure, although it is a demanding
surgery, is an effective method for the treatment of periprosthetic hip infection, with high implant survival and erradication
of the infection
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