Two-stage exchange Arthroplasty is a viable treatment for Periprosthetic joint infection in inflammatory diseases
- PDF / 828,640 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 85 Downloads / 202 Views
(2020) 21:681
RESEARCH ARTICLE
Open Access
Two-stage exchange Arthroplasty is a viable treatment for Periprosthetic joint infection in inflammatory diseases Qiao Jiang1,2,3†, Jun Fu2†, Wei Chai2,3, Li-Bo Hao2, Yong-Gang Zhou2,3, Chi Xu2* and Ji-Ying Chen1,2,3*
Abstract Background: Inflammatory diseases are chronic autoimmune systemic autoimmune diseases, which may increase the risk of prosthetic joint infection (PJI) after total joint arthroplasty (TJA). However, to our best knowledge, few studies have studied the association between inflammatory diseases and subsequent failure after two-stage exchange reimplantation. The aims of this study were to identify the differences in (1) serum markers, synovial indicators and pathology results and (2) treatment outcomes following two-stage exchange arthroplasty between patients with or without inflammatory diseases. Methods: A retrospective review of 184 patients with PJI who underwent two-stage revision from 2014 to 2018 was conducted. PJI was diagnosed by using the MSIS criteria. Serum biomarkers, synovial fluid, organism and pathology results at the time of the PJI diagnosis and reimplantation were compared between patients with or without inflammatory diseases. Treatment success was defined according to the Delphi-based consensus criteria; Kaplan-Meier survivorship curves of the patients were generated and compared. Results: There was no difference in the biomarkers, pathology results or organism profile at the time of the PJI diagnosis. At reimplantation, the patients with inflammatory diseases generally had higher values of serum markers than those without inflammatory diseases. However, synovial white blood cell count was comparable in patients with inflammatory diseases (1142.8 ± 1385.3*109/mL) and group C (1315.8 ± 1849.3*109/mL, p = 0.841). The total treatment success rate was 91.3% (92% for individuals with inflammatory diseases and 91.2% for the controls). The survivorship of the inflammatory disease group was comparable with that of the control group. Conclusion: Two-stage exchange arthroplasty is a viable option for PJIs with inflammatory diseases. Synovial fluid analysis may be less affected by inflammatory diseases than serum markers did in the diagnosis persistent infection at reimplantation. Keywords: Periprosthetic joint infection, Second-stage revision, Inflammatory diseases, Total joint arthroplasty
* Correspondence: [email protected]; [email protected] † Qiao Jiang and Jun Fu contributed equally to this work and are considered co-first authors. 2 Department of Orthopedic Surgery, The first Medical Center, Chinese PLA General Hospital, Beijing, China 1 Medical school of Chinese PLA, General Hospital of People’s Liberation Army, No.28 Fuxing Road, Haidian District, Beijing 100853, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduct
Data Loading...
