Success Rate of Fungal Peri-Prosthetic Joint Infection Treated by 2-Stage Revision and Potential Risk Factors of Treatment Failure: A Retrospective Study Article Swipe
Zhisen Gao
,
Xiang Li
,
Yinqiao Du
,
Yawen Peng
,
Wenming Wu
,
Yonggang Zhou
·
YOU?
·
· 2018
· Open Access
·
· DOI: https://doi.org/10.12659/msm.909168
YOU?
·
· 2018
· Open Access
·
· DOI: https://doi.org/10.12659/msm.909168
BACKGROUND The aim of this study was to investigate the success rate of fungal peri-prosthetic joint infection treated by 2-stage revision and related factors of treatment failure to offer a better treatment protocol. MATERIAL AND METHODS We reviewed 18 joints (13 knees and 5 hips) of 17 patients (10 women and 7 men) diagnosed with fungal peri-prosthetic joint infection from January 2000 to June 2015 at our institute. The mean follow-up was 65.1 months (range, 25-129 months). All joints were treated with complete debridement, implantation of antifungal-loaded cement spacers, at least 6 weeks of parenteral antifungal agents, and delayed reimplantation. RESULTS Notably, 15 joints were infected with Candida, and molds were isolated in 3 joints. The median duration of resection arthroplasty and reimplantation was 33.9 weeks (range, 12-132 weeks). Thirteen (10 knees and 3 hips, 72.2%) of the 18 joints (13 knees and 5 hips) had no recurrent or persistent infection, while the remaining 5 joints (3 knees and 2 hips, 27.8%) failed to control infection after reimplantation of prosthesis or spacer. The long interval between prosthesis resection and reimplantation (69 weeks vs. 23.1 weeks, p=0.240) and mixed bacterial infection (80% vs. 46.2%, p=0.314) were associated with higher failure rate. CONCLUSIONS Debridement with the retention of the prosthesis is not an ideal treatment protocol for fungal peri-prosthetic joint infection; thus, a two-stage revision could be valid. We suggest that 6 weeks of parenteral antifungal agents are necessary, and 6 subsequent weeks of oral antifungal treatment is also important. We do not recommend that the two-stage revision be performed on patients who have more than 2 host risk factors.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.12659/msm.909168
- OA Status
- hybrid
- Cited By
- 29
- References
- 34
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W2886623375
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W2886623375Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.12659/msm.909168Digital Object Identifier
- Title
-
Success Rate of Fungal Peri-Prosthetic Joint Infection Treated by 2-Stage Revision and Potential Risk Factors of Treatment Failure: A Retrospective StudyWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2018Year of publication
- Publication date
-
2018-08-10Full publication date if available
- Authors
-
Zhisen Gao, Xiang Li, Yinqiao Du, Yawen Peng, Wenming Wu, Yonggang ZhouList of authors in order
- Landing page
-
https://doi.org/10.12659/msm.909168Publisher landing page
- Open access
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YesWhether a free full text is available
- OA status
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hybridOpen access status per OpenAlex
- OA URL
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https://doi.org/10.12659/msm.909168Direct OA link when available
- Concepts
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Retrospective cohort study, Stage (stratigraphy), Medicine, Perioperative, Intensive care medicine, Surgery, Biology, PaleontologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
29Total citation count in OpenAlex
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2025: 4, 2024: 5, 2023: 4, 2022: 8, 2021: 5Per-year citation counts (last 5 years)
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34Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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