Alvand A, et al. - This study assessed mid-term outcome as well as factors that can impact the prognosis of endoprosthetic replacements (EPRs) for treatment of PJI and infected failed osteosyntheses around the hip and knee joint. As per findings, EPRs were supported as a treatment option for PJI in complex, multiply revised cases. Furthermore, researchers described PJI eradication rate of 72% with acceptable functional outcome.

Methods

• This retrospective review included all hip and knee EPRs performed between 2007-2014 for the management of chronic infection following complex arthroplasty or fracture fixation.
• Indication for EPR, number of previous surgeries, co-morbidites, and organism identified were recorded.
• PJI eradication rate, complications, implant survival, mortality, and functional outcome (Oxford Hip or Knee Score; OHS/OKS) were the outcome measures.

Results

• As per data, 69 EPRs (29 knee and 40 hip) were performed with a mean age of 68 years (43-92).
• Researchers detected polymicrobial growth in 36% of cases, followed by coagulase-negative staphylococci (28%) and staphylococcus aureus (10%).
• Findings demonstrated that 19 patients (28%) had infection recurrence; five were treated with irrigation and debridement, five with revision, one with above-knee amputation, and eight remain on long-term antibiotics.
• In addition, PJI eradication was achieved in 50 patients (72%); the chance of PJI eradication was greater in hips (83%) than in knees (59%) (p=0.038).
• Results revealed that the five-year implant survivorship was 81% (95% confidence interval 74-88%) and the mean OHS and OKS was 22 (4-39) and 21 (6-43) respectively.