Potential ability of reducing the interval between the stages of total hip replacement in the treatment of chronic periprothetic joint infection (prospective non-randomized comparative study)

Introduction. In the treatment of patients with chronic periprosthetic joint infection (PJI), two-stage revision arthroplasty (THR) remains the leading method of surgical treatment. At the same time, the optimal duration of time between the stages of THR has not been determined.Aim of the study. To study the effectiveness of 2-stage surgical treatment of PJI while reducing the time interval between the stages of THR.Materials and methods. The study included 65 patients with chronic PJI: 14 (1.9%) patients with short time intervals (ShT) between stages of THR (6-21 days), the second - 51 (7.0%) patients with long intervals (LoT, 22-100 days).Results and discussion. Bactericidal antibiotics and available drugs with antibiofilm activity were used. In the ShT group, there was no break in the antibiotic intake, in the LoT group there was a minimum (3 (1-6) days) (OR 0.8 CI95% 0.09-6.6). The time interval between the fi st and second stages of THR in the ShT group is 14 (10-17) days, in the LoT - 49 (41-66) days (p = 0.0005). Calculation of the ratio of the chances of recurrence of PJI to the duration of the interval established signifi ant relationships in the comparison groups: ShT OR 6.4 CI95% 1.2-34, LoT OR 28 CI95% 6.4-119. The HHS results in the ShT group (96 (92-97) points) did not signifi antly exceed the LoT data (93 (75-97) points), p = 0.513. The use of "OMS-Osteomyelitis" and fi ancing of high-tech medical care covers the costs of treating PJI, which in the ShT group is 392 (371-454) thousand rubles, LoT - 411 (363-449) thousand rubles. Conclusion. The time interval between operations of a two-stage THR P can be shortened to several days or weeks without the risk of increasing the proportion of relapses of PJI hip joints. The results of treating PJI with short (up to 21 days) and long (up to 100 days) intervals are comparable. Potential benefits of shortening treatment time in early social rehabilitation of patients.