Functional and Emotional Results Differ After Aseptic vs Septic Revision Hip Arthroplasty


Friedrich Boettner, MD

Friedrich Boettner, MD

Assistant Attending Orthopaedic Surgeon, Hospital for Special Surgery
Assistant Professor of Orthopaedic Surgery, Weill Cornell Medical College

Michael B. Cross, MD
Department of Orthopedic Surgery, Hospital for Special Surgery

Denis Nam, MD
Department of Orthopaedics Surgery, Hospital for Special Surgery
Weill Medical College of Cornell University

Tobias Kluthe, BS
Department of Orthopaedics, Münster University Hospital, Münster, Germany

Miriam Schulte, BS
Department of Orthopaedics, Münster University Hospital, Münster, Germany

Christian Goetze, MD
Department of Orthopaedics, Münster University Hospital, Münster, Germany

Abstract

Background 
It is widely believed that a deep implant infection leads to poor functional and emotional outcomes following total hip arthroplasty.

Questions/Purpose 
The purpose of this retrospective comparative review was to determine if patients who undergo two-stage, septic revision hip arthroplasty will have decreased emotional and general health scores, in addition to decreased function, compared to the aseptic revision group.

Patients and Methods 
One hundred forty-five of 195 patients who underwent aseptic total hip revision for aseptic loosening (mean follow-up#=#61 months) and 45 of 73 patients who underwent two-stage, septic revision hip arthroplasty (mean follow-up#=#48 months) met the inclusion criteria and had a technically successful outcome. All patients were retrospectively evaluated using Harris Hip Scores (HHS), ad hoc questions, and the SF-36 Health Survey.

Results 
The average HHS were 73.2#±#20.5 (aseptic) and 57.4#±#20.6 (septic). Significant differences in the SF-36 Health Survey were found between the two groups in: physical functioning (p#=#0.026) and role limitations due to physical health (p#=#0.004). No significant difference in SF-36 scores was seen in: Energy/Fatigue, General Health Perception, Personal or Emotional Problems, Role Limitations due to Emotional Well Being, Social Functioning, and Bodily Pain.

Conclusions 
Two-stage, septic revision produces a poor functional outcome compared to aseptic revision; however, the overall impact of a septic revision emotionally and socially was not significantly different than patients undergoing aseptic revision.

This article appears in HSS Journal: Volume 7, Number 3.
View the full article at springerlink.com.

About the HSS Journal

HSS Journal, an academic peer-reviewed journal, is published twice a year, February and September, and features articles by internal faculty and HSS alumni that present current research and clinical work in the field of musculoskeletal medicine performed at HSS, including research articles, surgical procedures, and case reports.

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