Health-related quality of life with long-term retention of the PROSthesis of Antibiotic Loaded Acrylic Cement system following infection resolution in low demand patients

Background: The study purpose was to (1) evaluate health-related quality of life (HRQL) with the PROSthesis of Antibiotic Loaded Acrylic Cement (PROSTALAC) in situ for infected total hip arthroplasty (THA), (2) determine infection resolution, and (3) compare subjects who underwent second stage surge...

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Published in:Journal of orthopaedic surgery (Hong Kong) Vol. 25; no. 2; p. 2309499017716257
Main Authors: Beaupre, Lauren A, Stampe, Kyle, Masson, Edward, O’Connor, Gregory, Clark, Marcia, Joffe, A Mark, Boychuk, Lesia R, Lavoie, Guy
Format: Journal Article
Language:English
Published: London, England SAGE Publications 01.05.2017
Sage Publications Ltd
SAGE Publishing
Subjects:
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents - therapeutic use
Antibiotics
Arthroplasty, Replacement, Hip - adverse effects
Arthroplasty, Replacement, Hip - instrumentation
Authorship
Bone Cements - therapeutic use
Cement
Female
Hip Prosthesis
Humans
Infections
Joint surgery
Longitudinal Studies
Male
Middle Aged
Osteoarthritis, Hip - surgery
Patients
Polymethyl Methacrylate - therapeutic use
Prospective Studies
Prostheses
Prosthesis Failure
Prosthesis-Related Infections - therapy
Quality of Life
Questionnaires
Reoperation
Retention
Surgeons
Surgery
Time Factors
Transplants & implants
Treatment Outcome
periprosthetic joint infection
total hip arthroplasty
infection management
health-related quality of life
ISSN:1022-5536, 2309-4990, 2309-4990
Online Access:Get full text
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Summary:Background: The study purpose was to (1) evaluate health-related quality of life (HRQL) with the PROSthesis of Antibiotic Loaded Acrylic Cement (PROSTALAC) in situ for infected total hip arthroplasty (THA), (2) determine infection resolution, and (3) compare subjects who underwent second stage surgery with those who retained the PROSTALAC on a longer term basis. Methods: Demographics, physical demand level, and comorbidities were recorded prospectively in 29 subjects followed to at least 24 months after initial PROSTALAC insertion. HRQL was evaluated using the Western Ontario McMaster Osteoarthritis Index (WOMAC) and RAND 36-Item Health Survey. Infection resolution was determined using a pre-specified clinical definition. Results: Twenty-five of 29 (86%) subjects’ infections resolved. Three subjects died, of whom two had resolved infections. For survivors, 22/26 (85%) completed HRQL evaluations. After PROSTALAC insertion, pain and function improved within 3–6 months and was retained at 24 months. Of those followed to 24 months, 7/22 (32%) subjects underwent second stage surgery. They were higher physical demand subjects (p = 0.03) than those not undergoing second stage surgery. We found no difference in WOMAC scores at 24 months between those who underwent second stage surgery and those who retained the PROSTALAC (p > 0.32). Discussion: The PROSTALAC system for THA appears to allow acceptable HRQL while in situ for at least 2 years in low physical demand patients. Subjects with higher physical demand levels are more likely to undergo second stage surgery. Conclusion: Further evaluation is required to determine whether longer term PROSTALAC retention may be appropriate for specific patient groups.
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ISSN:1022-5536
2309-4990
2309-4990
DOI:10.1177/2309499017716257