International Orthopaedics January 2015, Volume 39, Issue 1, pp 19–25

Pre-operative scoring system to determine the surgical strategy for periprosthetic hip infection

Oe, K., Iida, H., Ueda, N. et al.
Hip

Purpose

The aim of this study was to evaluate the results of one- and two-stage revision total hip arthroplasties (THAs) and to determine a rational surgical treatment strategy for periprosthetic hip infections.

Methods

We constructed a 12-point preoperative scoring system to suggest either one- or two-stage revision THAs, based on a retrospective analysis of 55 operative procedures. Prosthesis survival was analysed using the Kaplan-Meier method, and the validity of the scoring system was evaluated using receiver-operating characteristic curves.

Results

At the end point of implant removal due to recurrent infection, the ten year survival rates were 94 and 87 % for one- and two-stage revision THAs, respectively. One-stage revision THA was recommended for patients scoring >9 points. The risk of recurrent infection in patients scoring 4 points was 83 %. The sensitivity and specificity of a cut-off value of 4 points, determined by the scoring system, were 83 and 100 %, respectively.

Conclusions

The novel pre-operative scoring system was useful for the management of periprosthetic hip infections.


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