Year: 2025
Type: article
Study design: Observational Study
Abstract: INTRODUCTION: Revision total hip arthroplasty is a surgical challenge when undertaken for hip prosthetic joint infection (PJI). When PJI occurs in the setting of severe proximal femoral bone loss, proximal femoral replacement (PFR) can serve as an effective salvage strategy, restoring function in prosthetic hips that cannot be reconstructed otherwise. MATERIALS AND METHODS: This retrospective series from a high-volume revision hip surgeon comprises 15 PFRs in 14 patients. Infection was the indication for surgery in all cases. Thirteen patients had confirmed PJI as per the 2018 Musculoskeletal Infection Society (MSIS) criteria. The primary outcome measure was the eradication of infection. Secondary outcome measures included peri- and postoperative complications, re-operation, mobility, and death. The mean follow-up was three years. RESULTS: Infection was eradicated in 13 cases (86.6%). Of the two cases with infection, one was asymptomatic for seven years before PJI became evident again. Complications included hip dislocation (three episodes in two patients). One patient underwent revision of the acetabular component due to infected loosening. All but one patient were ambulatory with walking aids. Both patients with persistent or recurrent infection subsequently died. CONCLUSIONS: PFR is an option for patients with PJI for whom standard revision hip arthroplasty would be unsuitable and excision surgery unacceptable. This study suggests promising results for the eradication of PJI using PFR as a salvage procedure in this particularly challenging cohort. LEVEL OF EVIDENCE: The study is classified as level IV evidence.
Source: Cureus
DOI: 10.7759/cureus.95512
Authors: Sathya Lakpriya, Lucy Maling, Gihan Jayasinghe, Richard Slack
Institution: East Kent Hospitals University NHS Foundation Trust
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4415590507