Outcomes of two-stage revision arthroplasty in the treatment of patients with periprosthetic hip infection (retrospective cohort study)

Introduction Periprosthetic infection (PPI) is a serious challenge for orthopedic surgeons. Two-stage revision with an antibiotic-impregnated spacer is one of the most common methods for treating periprosthetic infection. Purpose To evaluate the functional results of the second stage of revision arthroplasty in patients with PPI and to determine the survival of the endoprosthesis components. Materials and methods We retrospectively studied the results of the second stage of treatment (removal of the spacer and installation of the endoprosthesis) in 23 patients admitted to the department for the period 2016-2019. All patients received a spacer during the first stage of treatment. The mean age of the patients was 53.7 ± 2.2 years. Males prevailed (91.3 %). Results Three patients developed infection recurrence in the follow-up period of 44.4 ± 1.9 months. The effectiveness of revision arthroplasty performed as the second stage of treatment was 87 %. The Harris Hip Score before the second examination was 42.3 ± 2.5 points, at the time of the last follow-up examination it was significantly higher, 78.32 ± 3.8 points (p = 0.000052; Z - 4.04). Discussion The success of two-stage revision arthroplasty is influenced by the factors associated with patients’ co-morbidities, pathogenicity of the pathogen identified at the first stage, as well as the features of the implants used and surgical tactics. Conclusion The second stage of revision arthroplasty in patients who received a spacer with an antibiotic for the treatment of periprosthetic infection at the first stage significantly improved their functional state. The Kaplan-Meier implant survival rate was 77.5 %.