Early results of one-stage septic revision arthroplasties with antibiotic-laden cement. A clinical and statistical analysis

Background. Periprosthetic infections will generally require revision arthroplasty. The one-stage revision arthroplasty with antibiotic-laden cement is hence an attractive therapeutic option, since it only requires one operation, has a low morbidity and, if successful, is cost-efficient. Materials and Methods. We performed one-stage revision arthroplasties. The exchanged prostheses were fixed with antibiotic-laden cement after biotic resistance was determined. All patients were treated with postoperative systemic antibiotics. Results. After a mean postoperative examination period of 18.4 months, we confirmed eradication of infection in 14 of 15 kneejoints and in 15 of 16 hipjoints. The mean duration of hospital stay was 23 days. Patients' satisfaction was high (93.55%) and the clinical results were satisfactory. Conclusion. Our analysis shows that our low early reinfection rate (6.45%) is within statistical expectation. Furthermore, we have showed that there is evidence to suggest that the rate of successful outcomes in one-stage revision arthroplasties, at least at the hip, is not different from the rate of two-stage revision arthroplasties and that the difference may be interpreted as stochastic deviation (P=0.264494). According to existing studies, an analogy to knee arthroplasties can be assumed. We demonstrated that one-stage revision is an adequate therapeutic option if patients are carefully selected and under the supervision of an experienced surgeon.