Retrospective Analysis of Infection Rate After Early Reoperation in Total Hip Arthroplasty
Retrospective Analysis of Infection Rate After Early Reoperation in Total Hip Arthroplasty
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DOI：
10.1007/s11999-010-1325-5
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发表时间：
2010-09-01
影响因子：
4.2
通讯作者：
Molloy, Robert
中科院分区：
文献类型：
--
作者：
Darwiche, Hussein;Barsoum, Wael K.;Molloy, Robert
感染是全髋关节置换术（THA）的严重并发症。在髋关节置换术急性恢复期的非自愿再手术有可能增加感染率，但风险尚未得到很好的确定，也不是这些感染髋关节的命运。因此，我们报告了接受THA的患者的感染率，这些患者在他或她的同一髋关节的任何手术干预的首次手术后90天内返回手术室。我们确定了60例接受THA的患者，在急性恢复期需要计划外和不可避免地返回手术室的患者。导致再次手术的初次手术并发症包括不稳定、假体周围骨折、硬件残留和神经探查。然后，我们回顾性审查了医疗记录，以确定感染率和植入物存活率。最短随访时间为1个月（平均3.7年，范围1个月至7年），包括所有在最短2年随访前需要切除的患者，该队列的感染率为20/60（33%）。这20例患者中有6例在再次手术后2年时保留了植入物，并被视为无感染。14例感染患者最终接受了二期再植或切除术。在急性恢复期不可避免的再次手术后，高比例的THA患者发生深部感染。再次手术的原因是潜在的可修改的并发症和情况，需要进一步调查，以描述协议，以尽量减少这些患者的感染风险。IV级，治疗研究。有关证据级别的完整描述，请参阅作者指南。
Infection is a devastating complication of total hip arthroplasty (THA). Unavoidable reoperation during the acute recovery phase of hip arthroplasty has the potential for an increased infection rate but the risk is not well established nor is the fate of these infected hips.We therefore report the infection rate for patients undergoing THA who returned to the operating room within 90 days of his or her index procedure for any surgical intervention on the same hip.We identified 60 patients undergoing THA referred to or treated at our institution who required an unplanned and unavoidable return to the operating room during the acute recovery phase. The complications of the initial surgery that resulted in reoperation included instability, periprosthetic fracture, retained hardware, and nerve exploration. We then retrospectively reviewed the medical records to determine the infection rate and implant survivorship. The minimum followup was 1 month (average, 3.7 years; range, 1 month to 7 years) and included all patients who required resection before a minimum 2-year followup.The infection rate for this cohort was 20 of 60 (33%). Six of these 20 retained their implants at 2 years after the reoperation and were considered infection-free. Two-stage reimplantation or resection was eventually performed in 14 of the infected patients.A high percentage of patients undergoing THA developed a deep infection after unavoidable reoperation during the acute recovery phase. The reasons for the reoperations were potentially modifiable complications and situations that deserve further investigation to delineate protocols to minimize the risk of infection in these patients.Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.