Abstract

SOUSA, Ricardo et al. Tratamento de Infeções Protésicas com Cirurgia de Revisão a Dois Tempos: resultados de um estudo prospetivo com abordagem protocolada. Rev. Port. Ortop. Traum. [online]. 2017, vol.25, n.2, pp.79-91. ISSN 1646-2122.

Study Goal: Revision surgery with implant removal, because it offers predictable results, is considered to be the gold standard in the treatment of prosthetic joint infections. Our belief is that a protocoled approach may offer better infection control as well as reduce patient morbidity. The goal of this paper is to present the results our management protocol and the results obtained with its implementation. Material and Methods: This is a prospective clinical study including patients with prosthetic joint infection treated between January/2012 and December/2015 thus allowing a twelve months’ minimum follow-up. Prosthetic joint infection definition followed internationally established criteria and medical and surgical treatment was performed in a standardized way. Every patient underwent prosthesis removal and high-dose antibiotic spacer implantation. Results: Twenty-nine patients (19 knees and e 10 hips) with a mean age of 67 years were included. There were two related deaths. Infection eradication was achieved in all cases, although it was not possible to complete the second stage in two cases. Among the 25 patients who completed the second stage, the mean time interval between stages was 11 weeks. There were no cases of infection relapse at a mean 30 months’ follow-up. Overall success rate is 86% (25/29). Conclusion: Following a protocoled approach resulted in good results with significant reduction of morbidity between the two stages without compromising safety.

Keywords : Revision hip arthroplasty; Revision knee arthroplasty; Prosthesis-Related Infections; Cohort Studies; Prospective Studies; 2-stage exchange; Anti-Bacterial Agents/therapeutic use; Treatment Outcome.

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