Abstract
Aim
There is a constant increase of total joint arthroplasties to improve the quality of life of an aging population. Prosthetic-joint infections are rare, with an incidence of 1–2%, but they represent serious complications in terms of morbidity and mortality. Different therapeutic options exist, but their management is still poorly standardized because of the lack of data from randomized trials. The aim of this retrospective study is to assess the infection eradication success rate, over the last ten years, using different patient adapted treatment options.
Method
Patients having a prosthetic-joint infection at Lausanne University Hospital (Switzerland) between 2006 and 2016 were included. The success rate depending on age, type of prosthesis, type of infection and type of surgical procedure was analyzed.
Results
444 patients (61% hips, 37% knees) were identified with a median age of 70 years. The success rate was 93% for two-stage exchange, 78% for one-stage exchange and 75% for debridement with retention of the prosthesis. The failure rate was higher for knee prosthetic-joint infections (27%) than hip infections (13%). Furthermore, chronic and in elderly prosthetic-joint infections seemed to have a worse prognosis.
Conclusions
The infection eradication depends on age, type of prosthesis, type of infection and type of surgical procedure, with three times less failure in two-stage exchange surgery.
