CLINICAL CHARACTERISTICS OF BONE DEFECTS IN PERIPROSTHETIC INFECTION OF THE HIP JOINT

Pavlo  Tanasiienko; Gennadiy  Kolov; Roman  Kozak

doi:10.21272/eumj.2026;14(2);566-573

Pavlo Tanasiienko Department of Surgery No. 1 Vinnytsia National Medical University named after M.I. Pirogov. Vinnytsia, Ukraine https://orcid.org/0000-0002-3064-5200
Gennadiy Kolov Department bone and joint infektion surgery of the State University "Institute of Traumatology and Orthopedics of the National Academy of Medical Sciences of Ukraine", Kyiv, Ukraine https://orcid.org/0000-0003-4191-1997
Roman Kozak State Institution "Institute of Traumatology and Orthopedics of the National Academy of Medical Sciences of Ukraine", Kyiv, Ukraine https://orcid.org/0000-0002-5132-027X

DOI: https://doi.org/10.21272/eumj.2026;14(2);566-573

Keywords: periprosthetic infection, diagnostics, radiological examination, bone defects, treatment

Abstract

The purpose of this analysis was to describe and characterize bone defects that were detected in patients of the observation array to unify the diagnostic algorithm, which will allow comparing the effectiveness of two-stage tactics of treating periprosthetic infection in different groups of patients.

Materials and methods: A prospective array was formed, which included 117 patients, who were divided into 2 groups. To the first experimental group, we assigned 53 patients with early (up to 4 weeks) onset of the infectious process after primary hip arthroplasty. To the second group, 42 cases of late manifestation of periprosthetic infection were assigned.

Results: The absence of bone defect or type I was significantly more common among patients with early development of periprosthetic infection, which was detected in 66.0% of patients and in 35.7% of patients with late development of periprosthetic infection. All types of type II defects were more common in patients with late development of periprosthetic infection, which was found in 52.4% of cases, in contrast to patients with early manifestation of periprosthetic infection, where this type was found in 33.9% of cases. Both types of type III bone defects were found only among patients with late periprosthetic infection, which was found in 11.9% of cases and were not found among patients with early manifestation of infectious prosthesis. Absence or type I bone defect was observed in most patients with early periprosthetic infection, which was found in 84.9% of cases and in most patients with late periprosthetic infection in 73.8% of cases. The distribution of type II bone defects of the hip was uniform in the observation groups, which indicates the absence of the influence of time determinants in the development of this type of bone defect. In the early stages of periprosthetic infection development, there are no severe types of bone defects, however, in patients with late manifestation, these defects were detected in 11.9% of cases.

Conclusions: Different types of bone defects are characteristic of different periods of periprosthetic infection. Early manifestations of periprosthetic infection are characterized by either the absence of bone defects or the first type of them. The distribution of type II bone defects of the thigh was uniform in the observation groups, which indicates the absence of the influence of time determinants in the development of this type of bone defect.

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References

Vrancianu CO, Serban B, Gheorghe-Barbu I, Czobor Barbu I, Cristian RE, Chifiriuc MC. The Challenge of Periprosthetic Joint Infection Diagnosis: From Current Methods to Emerging Biomarkers. Int J Mol Sci. 2023 Feb 21;24(5):4320. https://doi.org/10.3390/ijms24054320.

Parvizi J., Tan T.L., Goswami K., Higuera C., Della Valle C., Chen A.F., Shohat N. The 2018 Definition of Periprosthetic Hip and Knee Infection: An EvidenceBased and Validated Criteria. J Arthroplasty. 2018.33(5): 1309-1314.e2. https://doi.org/10.1016/j.arth.2018.02.078

McNally M, Sousa R, Wouthuyzen-Bakker M, Chen AF, Soriano A, Vogely HC, Clauss M, Higuera CA, Trebše R. The EBJIS definition of periprosthetic joint infection. Bone Joint J. 2021 Jan;103-B(1):18-25. https://doi.org/10.1302/0301-620X.103B1.BJJ-2020-1381.R1. PMID: 33380199; PMCID: PMC7954183.

Klement MR, Siddiqi A, Rock JM, Seyler TM, Parvizi J, Chen AF. Are All Periprosthetic Joint Infections the Same? Evaluating Major vs Minor Criteria. J Arthroplasty. 2018 May;33(5):1515-1519. https://doi.org/10.1016/j.arth.2017.12.010. Epub 2017 Dec 14. PMID: 29310922.

Wang SH, Xu C, Tan TL, Goswami K, Cooper AM, Parvizi J. Increased Postoperative Glucose Variability Is Associated With Adverse Outcome Following TwoStage Exchange Arthroplasty for Peri prosthetic Joint Infection. J Arthroplasty. 2020 May;35(5):1368-73. https://doi.org/10.1016/j.arth.2019.11.046

Tarabichi M, Shohat N, Goswami K, Alvand A, Silibovsky R, Belden K, Parvizi J. Diagnosis of Periprosthetic joint infection: the potential of next-generation sequencing. J Bone Joint Surg Am. 2018;100(2):147–154. https://doi.org/10.2106/JBJS.17.00434

Grammatopoulos G, Bolduc ME, Atkins BL, Kendrick BJL, McLardy-Smith P, Murray DW, et al.. Functional outcome of debridement, antibiotics and implant retention in periprosthetic joint infection involving the hip: a case-control study. Bone Joint J. 2017 May;99-B(5):614-622. https://doi.org/10.1302/0301-620X.99B5.BJJ-2016-0562.R2. PMID: 28455470.

Deirmengian C, McLaren A, Higuera C, Levine BR. Physician Use of Multiple Criteria to Diagnose Periprosthetic Joint Infection May Be Less Accurate Than the Use of an Individual Test. Cureus. 2022 Nov 12;14(11):e31418. https://doi.org/10.7759/cureus.31418. PMID: 36382315; PMCID: PMC9653271.

Burastero G, Alessio-Mazzola M, Cavagnaro L et al (2020) Conservative two-stage revision with primary components of infected total hip arthroplasty: an analysis of survival, clinical and radiographic outcomes. PLoS ONE. https://doi.org/10.1371/journal.pone.0239981

Acuña AJ, Do MT, Samuel LT, Grits D, Otero JE, Kamath AF. Periprosthetic joint infection rates across primary total hip arthroplasty surgical approaches: a systematic review and meta-analysis of 653,633 procedures Arch Orthop Trauma Surg Oct;142(10):2965-2977. https://doi.org/10.1007/s00402-021-04186-3.

Li Z, Xu C, Chen J. Articulating spacers: what are available and how to utilize them? Arthroplasty Apr 10;5(1):22. https://doi.org/10.1186/s42836-023-00167-6.

Ji B, Li G, Zhang X, Xu B, Wang Y, Chen Y, Cao L. Effective single-stage revision using intra-articular antibiotic infusion after multiple failed surgery for periprosthetic joint infection : a mean seven years' follow-up. Bone Joint J. 2022 Jul;104-B(7):867-874. https://doi.org/10.1302/0301-620X.104B7.BJJ-2021-1704.R1. PMID: 35775176.

Flaten D, Berrigan L, Spirkina A, Gin A. Risk of Treatment Failure for Prosthetic Joint Infections: Retrospective Chart Review in an Outpatient Parenteral Antimicrobial Therapy Program. Can J Hosp Pharm. 2023 Jan 9;76(1):14-22. https://doi.org/10.4212/cjhp.3264. PMID: 36683659; PMCID: PMC9817224.

Protsiuk VV, Vasiyk VL, Vasylchyshyn YM, Ushenko OG, Tomka YuYa. Differential diagnostics of aseptic and septic loosening of the artificial hip endoprothesis cup using polarization tomography methods. Proceedings of SPIE - The International Society for Optical Engineering. 2020; Vol 11509.

Sancho I, Otermin-Maya I, Gutiérrez-Dubois J, Aláez I, Hidalgo-Ovejero Á, Librero J, Portillo ME. Accuracy of a Novel Preoperative Failure Risk Model for Debridement Antibiotics and Implant Retention (DAIR) in Acute Prosthetic Joint Infection. Diagnostics (Basel). 2022 Aug 29;12(9):2097. https://doi.org/10.3390/diagnostics12092097. PMID: 36140498; PMCID: PMC9497597.