Re-infection Following One And Two Stage Revision Of Infected Total Hip Arthroplasty: Meta Analysis

BackgroundIn the treatment of infected total hip arthroplasty(THA),The choice of one stage revision or two stage revision still remains controversial.The aim of this study was to compare the re-infection of infected THA treated by one stage revision and two sate revision.Meta-analysis was performed to compare the re-infection rates between one stage revision and two sate revision.MethodsResearch the papers about infected THA treated by one stage revision and two tage revision on pubmed data and Medline data and EMBase data.Select the papers artificially,and filter according to the inclusion criteria and exclusion criteria.Assess the quality of the article and heterogeneity and bias analysis.Review Manger 5.3 is used for data analysis.ResultCollect 10 articles from 1084 articles finally.1116 cases of total hip arthroplasty cases was studied,which 480 cases were treated by one-stage revision and 636 cases were treated by two-stage revision.Re-infection rate between the two group results shows OR: 1.40,95% CI:[0.92,2.15],P = 0.12.There was no significant difference.1?If the soft tissue is healthy?the bone defect is small and the pathogen is determined,the re-infection rate results OR:0.44,95%CI:[0.13,1.41],P=0.17.There was no significant difference in two groups(P> 0.05);2?In the treatement of infected total hip arthroplasty,if not consider the soft tissue?bone defects and pathogens,the results shows OR:1.79,95%CI:[1.11,2.88],P=0.02.There was significant difference(P <0.05).Conclusion1?If the soft tissue is healthy?the bone defect is small and the pathogen is determined,The re-infection between one stage revision and two stage revision is similar,which is not statistically significant difference;2?In the treatment of the infected total hip arthroplasty,if not consider the soft tissue?bone defects and pathogens,the re-infection of two stage revision surgery is lower than one stage revision,which is not statistically significant difference;3?Considering the advantages of one stage revison,in the treated of infected total hip arthroplasty,if the local condition is good,one stage revision is recommended;otherwise,two stage revision is more wiser.