Septic versus aseptic hip revision: how different?

Carlo Luca Romanò, Delia Romanò, Nicola Logoluso, Enzo Meani
Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology 2010, 11 (3): 167-74

BACKGROUND: The few available studies directly comparing aseptic and septic joint revision surgery report conflicting results. We investigated whether two-stage revision of septic hip prosthesis with a preformed antibiotic-loaded spacer and an uncemented prosthesis provides hip function and quality of life similar to those provided by aseptic revision surgery in the medium term, as well as the associated direct hospital costs.

MATERIALS AND METHODS: We prospectively evaluated the hip function (Harris hip score) and quality of life (WOMAC and SF-12 scores) of 80 patients who underwent one-stage revision for aseptic loosening (Group A, 40 patients) or two-stage revision for septic total hip prostheses (Group S, 40 patients). Patients were matched for gender, age, and bone loss. A preformed antibiotic-loaded cement spacer was used for two-stage revision, and uncemented modular prostheses were implanted at revision in both groups. The minimum follow-up was 2 years (average 4 years; range 2-6 years).

RESULTS: We found no difference in infection recurrence or aseptic loosening rate in the two groups. Average Harris hip score increased similarly in both groups: from 19.1 to 74.0 in Group A versus 15.0-71.2 in Group S. Patient-reported quality-of-life questionnaires (SF-12 and WOMAC) at last follow-up were similar postoperatively, but the complication rate for Group S was twice that of Group A (20.8 versus 10%). Mean overall hospital-related costs of two-stage procedures were 2.2 times greater than those for aseptic revisions.

CONCLUSIONS: Two-stage revision for infected hip prostheses, using a preformed antibiotic-loaded cement spacer and uncemented revision prosthesis, offers a success rate comparable to noninfected revisions in the medium term but is associated with a higher complication rate and costs.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"