Total hip revision arthroplasty: does sepsis influence the results?

Area of Science:

• Orthopedic Surgery
• Infectious Disease

Background:

• Revision total hip arthroplasty (THA) is a complex procedure.
• Outcomes can be affected by the presence or history of sepsis.
• Literature comparing THA revision with and without sepsis is variable.

Purpose of the Study:

• To compare the outcomes of revision total hip arthroplasty in cases with and without sepsis.
• To identify challenges in comparing results due to differing methodologies.
• To recommend standardized approaches for future studies.

Main Methods:

• Literature review of recent studies on revision total hip arthroplasty.
• Analysis of success rates and infection rates in two groups: without sepsis and with/after sepsis.
• Identification of confounding factors affecting result comparability.

Main Results:

• In 661 revisions without sepsis: 54% excellent/good/satisfactory rate, 12% infection rate.
• In 1063 revisions with/after sepsis: 73% success rate, 17% reinfection rate.
• Significant heterogeneity in diagnostic criteria, antibiotic use, follow-up duration, and success definitions complicates direct comparison.

Conclusions:

• Direct comparison of revision THA outcomes with and without sepsis is challenging due to methodological inconsistencies.
• Patient-specific factors, surgical expertise, and standardized outcome/infection criteria are vital for successful revision THA.
• Annual independent patient examination and standardized rating systems are recommended for reliable data collection and comparison.