Evaluation of a staging system for infected hip arthroplasty

A previously reported staging system for prosthetic joint infection was evaluated in 26 consecutive patients with an infected hip arthroplasty. Six patients were treated by a definitive resection arthroplasty whereas the remaining 20 patients received delayed insertion of another hip arthroplasty. Four of the 20 patients (20%) receiving a new prosthesis had reinfection develop. The only variable in common among the patients who had reinfection was the use of a massive femoral structural allograft at reconstruction. Because of the small number of patients in this study, the power of statistical analysis did not allow definitive determination of the effect of the staging system score with respect to recurrent infection. Based on this study, recommendations can be suggested for addition and deletion of certain variables within the existing staging system. Although the concept of a staging system for treatment of an infected hip arthroplasty is promising, the number of patients required to evaluate the use of a staging system will require a multicenter collaborative study.