Comparison of single-stage versus two-stage revision for the treatment of chronic periprosthetic hip joint infections

IF 1.8 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2026-05-01 Epub Date: 2026-02-04 DOI:10.1016/j.jor.2026.02.021

Austin M. DeBoer , Nickolas L. Van Roekel , Travis D. Parkulo , Gaonhia Y. Moua , Sandy Vang , Scott B. Marston

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引用次数: 0

Abstract

Background

While two-stage revision is considered the gold standard, single-stage revision continues to gain popularity for the treatment of chronic periprosthetic joint infections. In this single-provider, single-protocol study, the outcomes between the two approaches were compared.

Methods

This was a retrospective study that included 63 consecutive adult patients who underwent single-stage or two-stage total hip revision arthroplasty for chronic periprosthetic joint infection between 2009 and 2020. Only the two-stage approach was performed between 2009 and 2014, while only single stage was performed between 2015 and 2020. Infections were classified using the Delphi-based consensus criteria. Three major outcomes were compared between the revision approaches: the rates of postoperative complications, reinfections, and reoperations.

Results

There were 43 (68.3%) single-stage and 20 (31.8%) two-stage revisions. The mean age was 59.5 ± 13 years with 35 (55.6%) women. The mean body mass index was 35.8 ± 9.1 kg/m². At the mean follow-up rate of 6.9 years (range, 2.1-10.8 years), the rate of no recurrence of infection was 81.4% in the single-stage cohort compared to 80.0% in the two-stage cohort (p = 1.000). Reoperation rate for single-stage revision due to a non-infectious reason was higher than two-stage (20.9% versus 15.0%; p = 0.7367). No statistically significant differences were noted for other postoperative complications.

Conclusion

Single-stage revision is as effective as two-stage revision for the treatment of chronic periprosthetic hip joint infections in patients with limited exclusion criteria.

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一期与二期翻修治疗慢性假体周围髋关节感染的比较

虽然两阶段翻修被认为是金标准，但单阶段翻修在治疗慢性假体周围关节感染方面继续受到欢迎。在这个单一提供者，单一方案的研究中，比较了两种方法之间的结果。方法：这是一项回顾性研究，纳入了2009年至2020年间连续63例因慢性假体周围关节感染而接受单期或两期全髋关节翻修置换术的成年患者。在2009年至2014年期间只进行了两阶段的方法，而在2015年至2020年期间只进行了单阶段的方法。使用基于delphi的共识标准对感染进行分类。比较两种翻修方式的三个主要结果：术后并发症、再感染和再手术的发生率。结果单期修正43例（68.3%），二期修正20例（31.8%）。平均年龄59.5±13岁，女性35例（55.6%）。平均体重指数为35.8±9.1 kg/m2。在平均随访时间为6.9年（范围2.1-10.8年）时，单期队列感染无复发率为81.4%，而两期队列感染无复发率为80.0% （p = 1.000）。非感染原因单期翻修的再手术率高于两期翻修（20.9%比15.0%;p = 0.7367）。其他术后并发症无统计学差异。结论对于排除标准有限的慢性假体周围髋关节感染患者，一期翻修术与二期翻修术治疗效果相同。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.