Our Summary

This research paper is a review of studies on a specific surgery method called partial two-stage exchange arthroplasty. This method is used to treat infections around the area of a hip replacement. The researchers looked at studies up until June 2018 to get an understanding of how successful this method is and what complications can arise.

They found 7 studies, involving 80 patients in total. The procedure mostly involved removing only a part of the hip replacement (the acetabular cup) and then putting in a temporary replacement that’s loaded with antibiotics. The most common infections were caused by a type of bacteria called staphylococci. The success rate of getting rid of the infection ranged from 81.3% to 100%, based on follow-ups between 19 and 70 months after the surgery.

However, the method was less successful when the infection was caused by MRSA, a type of bacteria that is resistant to many antibiotics.

The authors conclude that this partial two-stage surgery might be a useful option in some cases, particularly when removing the whole hip replacement could result in significant bone loss. But it’s not suitable when the infection is caused by bacteria that are resistant to multiple antibiotics. They also caution that because there are relatively few studies and patients involved, this method should only be used in very specific cases. More research is needed to better understand how effective this method is and who it might be most suitable for.

FAQs

  1. What is partial two-stage exchange arthroplasty and what is it used for?
  2. What was the success rate of the partial two-stage exchange arthroplasty method in treating infections around the area of a hip replacement?
  3. Why is this method less successful when the infection is caused by MRSA?

Doctor’s Tip

One tip a doctor might give a patient undergoing hip replacement surgery is to follow all post-operative care instructions carefully, including physical therapy exercises and medication regimens. This can help ensure a successful recovery and minimize the risk of complications. Additionally, patients should be vigilant about any signs of infection, such as increased pain, swelling, redness, or fever, and report them to their healthcare provider promptly.

Suitable For

Patients who are typically recommended for hip replacement surgery include those who have severe hip pain that limits daily activities, have hip stiffness or limited range of motion, have not experienced relief from other treatments such as medication or physical therapy, have hip pain that interferes with sleep, have hip pain that persists even when resting, and have arthritis or other conditions that have caused damage to the hip joint. Additionally, patients who have suffered a hip fracture or injury may also be recommended for hip replacement surgery.

Timeline

Before hip replacement:

  1. Patient experiences chronic hip pain and limited mobility.
  2. Patient undergoes medical evaluation and imaging tests to determine the need for hip replacement.
  3. Patient consults with orthopedic surgeon to discuss surgery options and risks.
  4. Patient undergoes pre-operative preparations such as blood tests, physical therapy, and medication adjustments.

After hip replacement:

  1. Patient undergoes hip replacement surgery, which involves removing damaged parts of the hip joint and replacing them with artificial components.
  2. Patient stays in the hospital for a few days for recovery and monitoring.
  3. Patient begins physical therapy and rehabilitation to regain strength and mobility in the hip joint.
  4. Patient continues to follow up with the orthopedic surgeon for post-operative care and monitoring of the hip replacement.
  5. Patient gradually resumes normal activities and experiences improved mobility and reduced hip pain.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with partial two-stage exchange arthroplasty for hip replacement infections?
  2. How successful is this method in treating infections compared to other treatment options?
  3. What factors determine whether a patient is a good candidate for partial two-stage exchange arthroplasty?
  4. How long is the recovery process after this type of surgery?
  5. Are there any long-term effects or considerations to keep in mind after undergoing this procedure?
  6. What is the likelihood of the infection recurring after undergoing partial two-stage exchange arthroplasty?
  7. Are there any specific precautions or lifestyle changes that should be followed post-surgery to prevent reinfection?
  8. How does this method compare to traditional hip replacement surgery in terms of outcomes and recovery?
  9. What is the success rate for patients with MRSA infections who undergo partial two-stage exchange arthroplasty?
  10. Are there any ongoing clinical trials or research studies investigating the effectiveness of this method for hip replacement infections?

Reference

Authors: Anagnostakos K, Meyer C. Journal: Arch Orthop Trauma Surg. 2019 Jun;139(6):869-876. doi: 10.1007/s00402-019-03180-0. Epub 2019 Mar 29. PMID: 30927063