Total hip arthroplasty following Girdlestone arthroplasty

Area of Science:

• Orthopedic Surgery
• Infectious Disease Management
• Arthroplasty Outcomes

Background:

• Complications of re-implantation after hip arthroplasty for septic arthritis (SA) or infected total hip arthroplasty (THA) and bipolar hemiarthroplasty (BHA) are not well-documented.
• A comparison between SA and infected THA/BHA re-implantation outcomes is lacking.

Purpose of the Study:

• To evaluate the outcomes of re-implantation THA after resection arthroplasty for primary SA versus infected THA or BHA.
• To compare complication rates and infection control between the two groups.

Main Methods:

• Retrospective evaluation of 19 hips in 19 patients undergoing re-implantation THA.
• Patients were divided into a SA group (12 hips) and an infected THA or BHA group (7 hips).
• Average follow-up was 77 months from re-implantation.

Main Results:

• Japanese Orthopaedic Association hip scores significantly improved post-re-implantation (50 to 80 points, p < 0.01).
• Overall complication rate was 57.9% (11/19), including deep infection (6 hips) and dislocation (7 hips).
• Relapsed infection occurred in 5/7 hips in the infected THA/BHA group versus 1/12 hips in the SA group (p < 0.05).

Conclusions:

• Re-implantation THA effectively improves daily living activities and gait function, with 94.7% of patients infection-free at latest follow-up.
• The overall rate of infection recurrence was 31.6%.
• Re-implantation following infected THA or BHA demonstrated a lower rate of infection control compared to re-implantation after primary SA.