One- versus two-stage septic hip and knee revision surgery: a comparative cohort outcome study with short- to mid-term follow-up
<p><strong>Introduction</strong>: One-stage revisions seem to have similar reinfection rates compared to two-stage revisions for the treatment of periprosthetic joint infections based on retrospective cohort studies with a large variety of indications and treatment protocols. This...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Copernicus Publications
2025-06-01
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| Series: | Journal of Bone and Joint Infection |
| Online Access: | https://jbji.copernicus.org/articles/10/185/2025/jbji-10-185-2025.pdf |
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| Summary: | <p><strong>Introduction</strong>: One-stage revisions seem to have similar reinfection rates compared to two-stage revisions for the treatment of periprosthetic joint infections based on retrospective cohort studies with a large variety of indications and treatment protocols. This study aimed to compare outcomes between comparable groups of one-stage and two-stage revision patients.</p>
<p><strong>Materials and methods</strong>: We performed a retrospective cohort study, where equal numbers of one-stage and two-stage patients (knee: <span class="inline-formula"><i>n</i>=24</span>; hip: <span class="inline-formula"><i>n</i>=40</span>) were randomly included with the same inclusion and exclusion criteria. Patient characteristics and infection-related outcomes at latest follow-up were obtained via chart review. Functional outcomes (knee: Knee Society Score (KSS), range of motion (ROM), and visual analogue scale (VAS) pain and satisfaction; hip: Oxford Hip Score (OHS), Hip Disability and Osteoarthritis Outcome Score–Physical Function Shortform (HOOS-PS), VAS pain and satisfaction, and European Quality of Life 5 Dimensions 3 Level version (EQ5D-3L)) preoperatively (hip only) and at 1-year follow-up were extracted from a revision database. Outcomes were compared between one- and two-stage groups and for knee and hip cases separately.</p>
<p><strong>Results</strong>: One- and two-stage groups were comparable for baseline characteristics. Reinfection occurred for both the knee and hip cohorts in one one-stage patient and one two-stage patient (<span class="inline-formula"><i>P</i>=1.00</span> for both cohorts). More adverse events, of which two were spacer-related, were observed in two-stage hip patients (<span class="inline-formula"><i>n</i>=7</span>) compared to in one-stage patients (<span class="inline-formula"><i>n</i>=2</span>) (<span class="inline-formula"><i>P</i>=0.13</span>). Functional outcomes did not differ between one- and two-stage patients for both knee and hip cohorts.</p>
<p><strong>Conclusions</strong>: This study showed no differences in terms of reinfection rates and functional outcomes between comparable groups of one- and two-stage septic knee and hip revision patients. A trend towards more adverse events in two-stage hip patients was seen, which was partly due to spacer complications.</p> |
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| ISSN: | 2206-3552 |