Optimal reimplantation timing in two-stage exchange for periprosthetic joint infection: an observative cohort study in Asian population
Abstract Background The optimal timing for reimplantation for periprosthetic joint infection (PJI) has not been established and varies from a few weeks to several months. The aim of this study was to assess the commendable time between implant removal and reimplantation in patients who underwent two...
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-023-07129-8 |
| _version_ | 1797363712819986432 |
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| author | Meng-Lun Tsai Allen Herng-Shouh Hsu Cheng-Ta Wu Po-Chun Lin Timothy L Tan Feng-Chih Kuo |
| author_facet | Meng-Lun Tsai Allen Herng-Shouh Hsu Cheng-Ta Wu Po-Chun Lin Timothy L Tan Feng-Chih Kuo |
| author_sort | Meng-Lun Tsai |
| collection | DOAJ |
| description | Abstract Background The optimal timing for reimplantation for periprosthetic joint infection (PJI) has not been established and varies from a few weeks to several months. The aim of this study was to assess the commendable time between implant removal and reimplantation in patients who underwent two-stage exchange arthroplasty for PJI. Methods We retrospectively reviewed 361 patients who were treated with two-stage exchange arthroplasty for hip and knee chronic PJI at our institution between January 2000 and December 2018. Patient characteristics, comorbidities, surgical variables, microbiology data, and time to reimplantation were recorded. All patients were followed for a minimum of one year. Treatment failure was defined by Delphi criteria. Logistic regression analyses were used to calculate survival rates and adjusted odds ratios (ORs) of treatment failure. Results In final analysis, 27 (7.5%) had treatment failure. Factors related to treatment failure including interim spacer exchange (OR, 3.13; confidence interval (CI), 1.04–9.09, p = 0.036), higher ESR level at reimplantation (OR, 1.85; CI, 1.05–3.57; p = 0.04), and time to reimplantation (OR, 1.00; CI, 1.003–1.005, p = 0.04). Performing revision arthroplasty surgery from 16 to 20 weeks had highest successful rate. The reimplantation over 24 weeks had a lower successful rate. However, no statistical significance in comparing each interval group. Conclusion Our study emphasized the importance of timely reimplantation in achieving successful outcomes. Factors such as ESR levels, spacer exchange, and the duration of time to reimplantation influenced the likelihood of treatment failure in two-stage exchange arthroplasty for hip and knee PJI. |
| first_indexed | 2024-03-08T16:25:06Z |
| format | Article |
| id | doaj.art-10947379eb844b34ad7f1f94efe6186a |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-03-08T16:25:06Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-10947379eb844b34ad7f1f94efe6186a2024-01-07T12:04:31ZengBMCBMC Musculoskeletal Disorders1471-24742024-01-012511810.1186/s12891-023-07129-8Optimal reimplantation timing in two-stage exchange for periprosthetic joint infection: an observative cohort study in Asian populationMeng-Lun Tsai0Allen Herng-Shouh Hsu1Cheng-Ta Wu2Po-Chun Lin3Timothy L Tan4Feng-Chih Kuo5Department of Orthopaedic Surgery, Kaohsiung Chang Gung Memorial HospitalDepartment of Orthopaedic Surgery, Kaohsiung Chang Gung Memorial HospitalDepartment of Orthopaedic Surgery, Kaohsiung Chang Gung Memorial HospitalDepartment of Orthopaedic Surgery, Kaohsiung Chang Gung Memorial HospitalDepartment of Orthopaedic Surgery, University of California, San FranciscoDepartment of Orthopaedic Surgery, Kaohsiung Chang Gung Memorial HospitalAbstract Background The optimal timing for reimplantation for periprosthetic joint infection (PJI) has not been established and varies from a few weeks to several months. The aim of this study was to assess the commendable time between implant removal and reimplantation in patients who underwent two-stage exchange arthroplasty for PJI. Methods We retrospectively reviewed 361 patients who were treated with two-stage exchange arthroplasty for hip and knee chronic PJI at our institution between January 2000 and December 2018. Patient characteristics, comorbidities, surgical variables, microbiology data, and time to reimplantation were recorded. All patients were followed for a minimum of one year. Treatment failure was defined by Delphi criteria. Logistic regression analyses were used to calculate survival rates and adjusted odds ratios (ORs) of treatment failure. Results In final analysis, 27 (7.5%) had treatment failure. Factors related to treatment failure including interim spacer exchange (OR, 3.13; confidence interval (CI), 1.04–9.09, p = 0.036), higher ESR level at reimplantation (OR, 1.85; CI, 1.05–3.57; p = 0.04), and time to reimplantation (OR, 1.00; CI, 1.003–1.005, p = 0.04). Performing revision arthroplasty surgery from 16 to 20 weeks had highest successful rate. The reimplantation over 24 weeks had a lower successful rate. However, no statistical significance in comparing each interval group. Conclusion Our study emphasized the importance of timely reimplantation in achieving successful outcomes. Factors such as ESR levels, spacer exchange, and the duration of time to reimplantation influenced the likelihood of treatment failure in two-stage exchange arthroplasty for hip and knee PJI.https://doi.org/10.1186/s12891-023-07129-8ReimplantationPeriprosthetic joint InfectionTiming of reimplantationTime to reimplantAsianExchange arthroplasty |
| spellingShingle | Meng-Lun Tsai Allen Herng-Shouh Hsu Cheng-Ta Wu Po-Chun Lin Timothy L Tan Feng-Chih Kuo Optimal reimplantation timing in two-stage exchange for periprosthetic joint infection: an observative cohort study in Asian population BMC Musculoskeletal Disorders Reimplantation Periprosthetic joint Infection Timing of reimplantation Time to reimplant Asian Exchange arthroplasty |
| title | Optimal reimplantation timing in two-stage exchange for periprosthetic joint infection: an observative cohort study in Asian population |
| title_full | Optimal reimplantation timing in two-stage exchange for periprosthetic joint infection: an observative cohort study in Asian population |
| title_fullStr | Optimal reimplantation timing in two-stage exchange for periprosthetic joint infection: an observative cohort study in Asian population |
| title_full_unstemmed | Optimal reimplantation timing in two-stage exchange for periprosthetic joint infection: an observative cohort study in Asian population |
| title_short | Optimal reimplantation timing in two-stage exchange for periprosthetic joint infection: an observative cohort study in Asian population |
| title_sort | optimal reimplantation timing in two stage exchange for periprosthetic joint infection an observative cohort study in asian population |
| topic | Reimplantation Periprosthetic joint Infection Timing of reimplantation Time to reimplant Asian Exchange arthroplasty |
| url | https://doi.org/10.1186/s12891-023-07129-8 |
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