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Modular megaprostheses yield high any-type failure rate but acceptable infection control rate in patients with chronic hip and knee periprosthetic joint infection and severe bone loss: a single-center experience

The result's identifiers

  • Result code in IS VaVaI

    <a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064203%3A_____%2F25%3A10505701" target="_blank" >RIV/00064203:_____/25:10505701 - isvavai.cz</a>

  • Alternative codes found

    RIV/00216208:11110/25:10505701 RIV/00216208:11130/25:10505701

  • Result on the web

    <a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=FbOo5_kZ6N" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=FbOo5_kZ6N</a>

  • DOI - Digital Object Identifier

    <a href="http://dx.doi.org/10.5194/jbji-10-479-2025" target="_blank" >10.5194/jbji-10-479-2025</a>

Alternative languages

  • Result language

    angličtina

  • Original language name

    Modular megaprostheses yield high any-type failure rate but acceptable infection control rate in patients with chronic hip and knee periprosthetic joint infection and severe bone loss: a single-center experience

  • Original language description

    Chronic periprosthetic joint infections (PJIs) complicated by severe bone loss are challenging cases that require complex and specialized treatment approaches. Megaprosthetic replacement has gained in popularity in the setting of chronic hip and knee PJI; however, only a limited number of studies reporting on its utility are available. Thus, we aimed to review our cohort of patients with this specific condition who received modular megaprosthesis (MMP) as a limb salvage option in order to assess the failure rates, infection control, and implant longevity. We retrospectively reviewed electronic medical records of 61 patients who received MMPs for chronic hip and knee PJI between 2012 and 2024. The mean follow-up was 6.6 +- 3.5  years. Failures were classified according to the Henderson classification. Kaplan-Meier survival curves were used to assess failure-free, infection-free, and overall implant survival. Cox regression analysis was performed to identify variables associated with MMP failure. Among the 61 patients, 37.7 % experienced any type of MMP failure, with infection recurrence being the most common reason for failure (60.9 %), followed by structural failure of the implant (17.4 %). At the 5-year follow-up, failure-free survival, infection-free survival, and revision-free survival were 65.8 %, 80.0 %, and 70.5 %, respectively. McPherson host grade C was significantly associated with implant failure (hazard ratio (HR) 3.1; 95 % confidence interval 1.4-7.6; P = 0.024 ). Conclusively, MMPs represent a valuable treatment option for patients with chronic hip and knee PJI and large bone defects. While infection control is acceptable, the rates of any-type failure are high. These findings should be considered during preoperative patient counseling.

  • Czech name

  • Czech description

Classification

  • Type

    J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database

  • CEP classification

  • OECD FORD branch

    30211 - Orthopaedics

Result continuities

  • Project

  • Continuities

    I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Others

  • Publication year

    2025

  • Confidentiality

    S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Data specific for result type

  • Name of the periodical

    Journal of Bone and Joint Infection

  • ISSN

    2206-3552

  • e-ISSN

    2206-3552

  • Volume of the periodical

    10

  • Issue of the periodical within the volume

    6

  • Country of publishing house

    DE - GERMANY

  • Number of pages

    10

  • Pages from-to

    479-488

  • UT code for WoS article

    001621725500001

  • EID of the result in the Scopus database

    2-s2.0-105023183256