International Orthopaedics December 2014, Volume 38, Issue 12, pp 2477–2481

Routine one-stage exchange for chronic infection after total hip replacement

Jenny, JY., Lengert, R., Diesinger, Y. et al.
Hip

Purpose

We hypothesized that a routine one-stage exchange for treatment of chronically infected total hip replacement (THR) will lead to (1) a higher rate of infection recurrence and (2) a poorer hip outcome than the published rates after two-stage exchange.

Methods

Sixty-five cases have been treated consecutively with one-stage exchange. All patients have been followed for a period of three to six years or until death or infection recurrence.

Results

The five-year rate for infection recurrence was 16 %. The five-year survival rate for recurrence of the index infection was 8 %. Forty-two percent of the hips had a good or excellent PMA score, and 46 % a good or excellent OH score.

Conclusions

Routine one-stage exchange was not associated with a higher recurrence rate and a poorer hip function than previously published series of two-stage exchange. Therefore, there is little support to choose two-stage exchange as the routine treatment for management of chronically infected THR.


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