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Master Thesis

État des lieux de la prise en charge des prothèses de hanche infectées au CHU de Caen de 2006 à 2016

Abstract : Introduction: prosthesis hip joint infection is a serious complication, the surgical strategy between one-stage revision and two-stage revision and indications for Debridement, antibiotics and implant retention (DAIR) is still debated. The aims of this study were to evaluate which methods produced superior outcomes Methods: a retrospective study was performed including 182 patients with a prosthesis hip joint infection who had undergone either one-stage revision, two- stage revision surgery or DAIR at a single stage between 2006 and 2016. The minimum follow-up was 24 months and a PMA score as well as a Harris Hip Score was achieved at the last follow-up. Results: the average follow-up was 52.4 months. The rate of infection control was 94% (53/56) in the one-stage group, 74,1% (46/62) in the two-stage group and 68,7% (44/64) in DAIR group (p = 0.001). In the DAIR group, the rate of infection control in acute surgical site infection was 79,6% (39/49) and was 29,4% (5/17) in acute hematogenous infection (p<0,001) The mean of PMA score and Harris Hip score was 13.5±4.17 and 69.0±21.5 for the one-stage group, 14.0±3.6 and 66.5±16.0 for the two-stage group and 14.6±3.4 and 74.4±17.7 for DAIR groups (p = 0.38 and p = 0.37). Conclusion: results of this study suggest that for prosthesis hip joint infections, one-stage revision is the surgical treatment giving the best cure rate with the same functional result as two-stage and DAIR. Level of evidence: Level 4.
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https://dumas.ccsd.cnrs.fr/dumas-02943973
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Submitted on : Monday, September 21, 2020 - 9:53:51 AM
Last modification on : Thursday, December 10, 2020 - 3:34:12 AM
Long-term archiving on: : Tuesday, December 22, 2020 - 6:04:41 PM

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Bertrand Lecoeur. État des lieux de la prise en charge des prothèses de hanche infectées au CHU de Caen de 2006 à 2016. Médecine humaine et pathologie. 2020. ⟨dumas-02943973⟩

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