Single-stage versus two-stage revision of total hip replacement for contained periprosthetic infection

Objective
In this article, single-stage exchange arthroplasty for periprosthetic hip infection was compared with the two-stage revision protocol in patients without draining sinuses.
Background
Staged revision for periprosthetic infection of the hip is an accepted and widely used technique by many surgeons. However, single-stage exchange of the hip prosthesis remains an attractive option to some.
Patients and methods
Fifty-two patients with evidence of periprosthetic infection underwent preoperative aspiration of the affected hip. The organism was identified in 33/52 patients, and single-stage revision was performed. The remaining 19 patients underwent two-stage exchange arthroplasty. All patients had cemented cup and long cementless stem.
Results
At an average 4 years (range: 2–7 years) postoperatively, only one case of persistent infection was found in the single-stage group, which showed a success rate of 97%, in comparison with 95% success rate in the staged protocol.
Conclusion
Single-stage exchange achieves excellent success rates in patients with contained infection when the organism is identified preoperatively.