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Similar Risk of Re-Revision in Patients after One- or Two-Stage Surgical Revision of Infected Total Hip Arthroplasty: An Analysis of Revisions in the Swedish Hip Arthroplasty Register 1979-2015

Journal article
Authors Karin Svensson
Ola Rolfson
Johan Kärrholm
Maziar Mohaddes
Published in Journal of Clinical Medicine
Volume 8
Issue 4
ISSN 2077-0383
Publication year 2019
Published at Institute of Clinical Sciences, Department of Orthopaedics
Language en
Keywords hip arthroplasty, revision surgery, infection, joint infection, thas
Subject categories Orthopedics


Late chronic infection is a devastating complication after total hip arthroplasty (THA) and is often treated with surgery. The one-stage surgical procedure is believed to be the more advantageous from a patient and cost perspective, but there is no consensus on whether the one- or two-stage procedure is the better option. We analysed the risk for re-revision in infected primary THAs repaired with either the one- or two-stage method. Data was obtained from the Swedish Hip Arthroplasty Register and the study groups were patients who had undergone a one-stage (n = 404) or two-stage (n = 1250) revision due to infection. Risk of re-revision was analysed using Kaplan-Meier analysis with log-rank test and Cox regression analysis. The cumulative survival rate was similar in the two groups at 15 years after surgery (p = 0.1). Adjusting for covariates, the risk for re-revision due to all causes did not differ between patients who were operated on with the one- or two-stage procedure (Hazard Ratio (HR) = 0.9, 95% Confidence Interval (C.I.) = 0.7-1.2, p = 0.5). The risk for re-revision due to infection (HR = 0.7, 95% C.I. = 0.4-1.1, p = 0.2) and aseptic loosening (HR = 1.2, 95% C.I. = 0.8-1.8, p = 0.5) was similar. This study could not determine whether the one-stage method was inferior in cases when the performing surgeons chose to use the one-stage method.

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