Resection arthroplasty following infected total hip replacement arthroplasty

Area of Science:

• Orthopedic surgery
• Infectious disease management
• Rehabilitation medicine

Background:

• Infected total hip replacement arthroplasty poses significant challenges.
• Resection arthroplasty is a salvage procedure for managing such infections.
• Functional outcomes after this procedure require thorough evaluation.

Purpose of the Study:

• To assess the functional level of patients following resection arthroplasty for infected total hip replacement.
• To identify factors influencing functional outcomes in this patient cohort.
• To evaluate gait parameters and energy expenditure post-resection arthroplasty.

Main Methods:

• Retrospective evaluation of 39 patients (41 hips) who underwent resection arthroplasty.
• Assessment of functional status, wound healing, and pain.
• Gait analysis using foot-switch studies (gait velocity, single-limb stance time).
• Metabolic studies including oxygen consumption and heart rate measurements.

Main Results:

• 83% of patients were minimal community ambulators or nonambulators; only 2 walked without assistive devices.
• 93% reported persistent hip pain at last follow-up.
• Gait velocity averaged 35 m/minute (41% of normal); oxygen consumption was 264% of normal.
• Healed wounds and heterotopic ossification were associated with better function; chronic drainage correlated with worse outcomes.

Conclusions:

• Resection arthroplasty for infected total hip replacement yields poor functional results and high rates of persistent pain.
• Factors like wound status and heterotopic ossification significantly impact functional recovery.
• The procedure leads to substantial metabolic cost, exceeding that of above-knee amputation.