Evaluation Of The Therapeutic Effect Of Partial Two-stage Exchange On Periprosthetic Joint Infection After Total Hip Arthroplasty

Objective This study was conducted to evaluate the efficacy of partial two-stage exchange(PTE)for infected total hip arthroplasty(THA)in order to improve surgical treatment outcomes.Methods 12 patients of infected THA treated by PTE between September 2000 and February 2016 were involved,among which,7 males and 5 females,with an average of 59 years old(range,40-74 years old).Nine patients underwent initial unilateral THA.Two patients received multiple unilateral THAs,and one patient underwent bilateral THA.Preoperative clinical characteristics and treatment outcomes were analyzed.The clinical hip function was scored by the Harris hip score.VAS score was used to assess the patient's pain perception.Using the questionnaire to record the patient's subjective satisfaction.Results All 12 patients were followed up for a mean of 33.3 months(range,24-48 months).No recurrence of infection was found in 11 patients after surgery,and the success rate was 92%.Only 1 patient suffered infection and get treated after another surgical intervention.The preoperative Harris score of 12 patients was 23-57,with an average of 40.83±10.62.All patients had significant improvement in hip function after the operation.The Harris score increased to 59.58±4.34 one month after surgery,and 64.58±9.08 after three months,which was as high as 86.75±4.58 at the last follow-up.The difference was statistically significant compared with preoperative.The patient's subjective satisfaction rating was 100%.Conclusions PTE can be a new alternative treatment for an infection after THA.The infection control rate and clinical outcome are comparable to those of total two-stage exchange while less harm.