A one-stage procedure may be the best way to treat an infected hip replacement, according to a new analysis.
The one-stage procedure is better than a two-stage procedure which seeks to eradicate infection with antibiotics, according to an analysis at Bristol University’s medical school.
In the one-stage procedure, the infection is treated by removal of the implant together with excision of infected tissue at the same time. A new joint is inserted as part of the same procedure.
The researchers conclude that the one-stage procedure is as good “if not better” than the two-stage procedure.
The findings come from an analysis of data from 44 studies into the two procedures. The researchers are undertaking their own trial in Bristol of the two approaches comparing patient reported outcomes.
Researcher Andrew Beswick said: "Our research and the subsequent adoption of the one-stage strategy by surgeons and hospitals, could improve lives, prevent unnecessary deaths, and save money."
Fellow researcher Dr Setor Kunutsor said: "For several decades, the two-stage procedure has been presumed to be more effective than the one-stage. However, it has disadvantages for patients such as having two major surgical procedures, significant pain and limited function between stages, long hospital stays, as well as high healthcare costs.
“The one-stage strategy has potential advantages for patients which include having only one major surgery, shorter time in hospital, reduced functional impairment, and is less expensive.
"When the research team analysed the collected data, the findings confirmed what we had suspected all along – the one-stage strategy may be as effective as, or better than the two-stage strategy.”
One- and two-stage surgical revision of peri-prosthetic joint infection of the hip: A pooled individual participant data analysis of 44 cohort studies. European Journal of Epidemiology April 2018
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