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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Two-stage revision for prosthetic joint infection: predictors of outcome and the role of reimplantation microbiology
Journal of Antimicrobial Chemotherapy, Volume 65, No. 3, Article dkp469, Year 2010
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Description
Objectives: We describe rates of success for two-stage revision of prosthetic joint infection (PJI), including data on reimplantation microbiology. Methods: We retrospectively collected data from all the cases of PJI that were managed with two-stage revision over a 4 year period. Patients were managed with an antibiotic-free period before reimplantation, in order to confirm, clinically and microbiologically, that infection was successfully treated. Results: One hundred and fifty-two cases were identified. The overall success rate (i.e. retention of the prosthesis over 5.75 years of follow-up) was 83%, but was 89% for first revisions and 73% for re-revisions [hazard ratio=2.9, 95% confidence interval (CI) 1.2-7.4, P=0.023]. Reimplantation microbiology was frequently positive (14%), but did not predict outcome (hazard ratio=1.3, 95% CI 0.4-3.7, P=0.6). Furthermore, most unplanned debridements following the first stage were carried out before antibiotics were stopped (25 versus 2 debridements). Conclusions: We did not identify evidence supporting the use of an antibiotic-free period before reimplantation and routine reimplantation microbiology. Re-revision was associated with a significantly worse outcome. © The Author 2010. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.
Authors & Co-Authors
Bejon, Philip A.
United Kingdom, Oxford
Nuffield Orthopaedic Centre
United Kingdom, Oxford
University of Oxford
Berendt, Anthony R.
United Kingdom, Oxford
Nuffield Orthopaedic Centre
Atkins, Bridget L.
United Kingdom, Oxford
Nuffield Orthopaedic Centre
United Kingdom, Oxford
John Radcliffe Hospital
Gundle, Roger
United Kingdom, Oxford
Nuffield Orthopaedic Centre
Byren, Ivor
United Kingdom, Oxford
Nuffield Orthopaedic Centre
Statistics
Citations: 194
Authors: 5
Affiliations: 3
Identifiers
Doi:
10.1093/jac/dkp469
ISSN:
14602091
Research Areas
Cancer
Environmental
Study Design
Cohort Study