Summary

Eradication of the periprosthetic hip and knee infection by one-stage prosthesis exchange was successful in 97% of patients. The main reason for SSI was the development of a new infection with a different pathogen (15% of initial cases).

Abstract

Introduction

The objective of this study was to analyze failures after one-stage exchange for periprosthetic hip and knee infection to determine if the failures were due to a persistence or recurrence of the initial infection or the development of a new infection

Methods

A retrospective analysis was done of 171 patients (96 men and 75 women) with a mean age of 69 years. Surgery and antibiotic treatment were carried out in a standardized manner. All patients were followed for at least two years. Any surgical site infections (SSI) according to the MSIS definition were recorded. The SSI was considered a persistence or recurrence of the initial infection if the pathogen(s) responsible for the initial infection and the SSI were identical. The SSI was considered a new infection if the pathogen(s) responsible for the initial infection and the SSI were different.

Results

Thirty-three infections (19%) were recorded during the follow-up period: 5 were a persistence or recurrence of the initial infection (3% of patients, 15% of failures), 25 were a new infection (15% of patients, 76% of failures), while 3 could not be classified (2% of patients, 9% of failures).

Conclusion

Eradication of the periprosthetic hip and knee infection by one-stage prosthesis exchange was successful in 97% of patients. The main reason for SSI was the development of a new infection with a different pathogen (15% of initial cases). These new pathogens were probably introduced into the surgical field during revision surgery.