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

Kód výsledku v 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>

Nalezeny alternativní kódy

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

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

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

Popis výsledku v původním jazyce

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.

Název v anglickém jazyce

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

Popis výsledku anglicky

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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30211 - Orthopaedics

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2025

Kód důvěrnosti údajů

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

Název periodika

Journal of Bone and Joint Infection

ISSN

2206-3552

e-ISSN

2206-3552

Svazek periodika

10

Číslo periodika v rámci svazku

6

Stát vydavatele periodika

DE - Spolková republika Německo

Počet stran výsledku

10

Strana od-do

479-488

Kód UT WoS článku

001621725500001

EID výsledku v databázi Scopus

2-s2.0-105023183256