Outcomes, Complications, and Eradication Rates of Two-Stage Revision Surgery for Periprosthetic Shoulder, Elbow, Hip, and Knee Infections: A Systematic Review.

Autor:	Mercurio, Michele, Cofano, Erminia, Colace, Stefano, Piro, Federico, Cerciello, Simone, Galasso, Olimpio, Gasparini, Giorgio
Předmět:	PROSTHESIS-related infections VISUAL analog scale TREATMENT effectiveness SHOULDER joint STAPHYLOCOCCUS aureus DESCRIPTIVE statistics SURGICAL complications HIP joint KNEE joint SYSTEMATIC reviews MEDLINE REOPERATION MEDICAL databases ONLINE information services BACTERIAL diseases DATA analysis software CONFIDENCE intervals QUALITY assurance ELBOW joint RANGE of motion of joints EVALUATION
Zdroj:	Prosthesis (2673-1592); Oct2024, Vol. 6 Issue 5, p1240-1258, 19p
Abstrakt:	Background/Objectives: Periprosthetic joint infection (PJI) is one of the most common complications after joint replacement. Two-stage revision remains the standard of care in chronic infections. The aim of this systematic review was to investigate the outcomes, complications, and eradication rates of two-stage revision surgery to treat PJI of the shoulder, elbow, hip, and knee. Methods: A total of 36 studies were included. Patient demographics, follow-up, the visual analog scale (VAS) for pain, the Constant–Murley score (CMS) for shoulder, the Harris Hip Score (HHS) for hip, the Knee Society Score (KSS) for knee, the range of motion (ROM), number and types of complications, and eradication rate were recorded. Results: A total of 2484 patients were identified, of whom 145, 29, 1269, and 1041 underwent two-stage revision surgery for shoulder, elbow, hip, and knee infections, respectively. The overall mean follow-up was 5.7 ± 4.5 years. The overall mean time of re-implantation was 20.8 ± 21.3 weeks. The most common causative bacteria were Cutibacterium acnes (32.7%) for shoulder, Methicillin-Sensitive Staphylococcus aureus (44.4%) for elbow, and Staphylococcus coagulase negative (CNS) (31.3% and 23%) for hip and knee infection, respectively. The mean overall preoperative VAS score was 6.7 ± 2.3, while, postoperatively, the mean score was 4.5 ± 2.7 (p < 0.001). A total of 2059 out of 2484 patients (82.9%) experienced eradication. Conclusions: Two-stage revision is an effective procedure to treat PJI with an overall eradication rate of 83%. A significant recovery of functionality and a decrease in residual pain can be achieved after surgery. Aseptic loosening and re-infection were the most common complications in shoulder and hip infections. Death rate was high in knee infections. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
Externí odkaz:	Zobrazit plný text záznamu