Curative treatment of prosthetic joint infection in patients younger than 80 vs. 80 or older
| Autor: | Valérie Zeller, Jean-Marc Ziza, Luc Lhotellier, Benoit Villain, Simon Marmor, Younes Kerroumi, Chloé Jamakorzyan, Vanina Meyssonnier, Beate Heym |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Prosthesis-Related Infections Joint replacement Arthroplasty Replacement Hip medicine.medical_treatment Risk Assessment Cohort Studies 03 medical and health sciences 0302 clinical medicine Rheumatology medicine Humans In patient Prospective Studies 030212 general & internal medicine Arthroplasty Replacement Knee Geriatric Assessment Device Removal Aged Aged 80 and over 030203 arthritis & rheumatology business.industry Age Factors Prosthetic joint infection Prognosis Arthroplasty Anti-Bacterial Agents Surgery Treatment Outcome Curative treatment Curative surgery Female France Hip Prosthesis Knee Prosthesis Complication business |
| Zdroj: | Joint Bone Spine. 86:369-372 |
| ISSN: | 1297-319X |
| Popis: | Prosthetic joint infection (PJI) is a serious complication of joint replacement surgery. The major pharmacological and surgical treatments required by PJI increase the risk of peri-operative complications in elderly patients. The increase in life expectancy combined with procedural advances make these treatments possible even in the oldest patients. Here, our objective was to compare the characteristics and outcomes of curative PJI treatment in patients 80 years vs. ≥ 80 years.A prospective single-center design was used to compare the characteristics and outcomes of curative treatment for hip or knee PJI in patients 80 years and ≥ 80 years admitted in 2004-2014.Of 765 patients admitted for PJI, 590 were 80 years and 124 were ≥ 80 years. Medical history and comorbidities were similar in the two groups. The older group had a significantly higher proportion of patients with American Society of Anesthesiologists Scores ≥ 3 and with streptococcal infection (20% vs. 13%, P 0.05). After complete surgical excision and prolonged antibiotic therapy, the only event whose frequency differed significantly between the two groups was PJI-related death, which was more common in the older patients (6.5% vs. 0.8%, P 0.05). The 2-year survival rate after one-stage exchange arthroplasty was 90% in the ≥80 year group.Patients aged 80 years or older are eligible for the same curative pharmacological and surgical PJI treatments used in their younger counterparts. Before surgery, the risk/benefit ratio of the major surgical procedure required to treat PJI must be assessed on a case-by-case basis. |
| Databáze: | OpenAIRE |
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