Related Experiment Video
Updated: Feb 17, 2026
Author Spotlight: Advancing Research on Candida albicans Biofilm-Associated Prosthetic Joint Infections
Published on: February 2, 2024
A comparative analysis of microbial pathogens and survivorship between native and prosthetic hips following
Yagiz Ozdag1,2,3, Gabriel S Makar1, Alex Tang2,3
1Department of Orthopaedic Surgery, Geisinger Medical Center, 100 N Academy Ave, Danville, PA, 17822, USA.
Background:
There is limited data that describe the microbiological profile of patients requiring Girdlestone resection arthroplasty (GRA) after deep infection for either a prosthetic or native hip joint. Moreover, there is little known about the mortality rates compared between groups. The purpose of this study was to describe the isolated microbial pathogens after GRA and to compare survival rates and demographic data between native and prosthetic hips.
Methods:
A retrospective review from 2007 to 2022 was performed identifying a consecutive cohort of patients undergoing GRA within an integrated healthcare system with a minimum follow-up of 2-years. Patients were separated into two groups: native and prosthetic (hemiarthroplasty or total hip arthroplasty). Data collected included baseline demographic information, intraoperative cultures, and mortality data.
Results:
A total of 102 cases (80 native, 22 prosthetic) were included. Most cases in the prosthetic cohort were indicated for deep infection (21/22 vs. 45/80). Prosthetic patients were older (71.1 vs. 50.3-years-old) and had higher body mass index (31.3 vs. 25.7 kg/m2) than the native cohort (p < 0.01). There was no difference in microbiological profiles. The most common organism identified was Staphylococcus species followed by multi-organism. Mortality rates were significantly higher in the prosthetic group than the native group (72 % vs. 45 %, p = 0.029) with a shorter time to death from index GRA (1683.5 vs 0.1002 days, p = 0.009). Overall 10-year survivorship was greater in native versus prosthetic hips (41.3 % vs. 17.1 %, p = 0.004). Subgroup analysis performed for septic patients revealed similar findings.
Conclusion:
While there is no difference in micro-organism profiles between native and prosthetic hip infections following GRA, prosthetic patients had significantly worse survivorship. Both groups demonstrated poor 10-year survivorship regardless of septicemia. Careful consideration of patient co-morbidities, surgical history, and indication can help predict prognosis and guide shared decision-making.
