Evidence map›Paper›PMID 29623671›Full record

SynthesisEuropean journal of epidemiology2018

One- and two-stage surgical revision of peri-prosthetic joint infection of the hip: a pooled individual participant data analysis of 44 cohort studies.

Setor K Kunutsor, Michael R Whitehouse, Ashley W Blom, Tim Board, Peter Kay, B Mike Wroblewski, Valérie Zeller, Szu-Yuan Chen, Pang-Hsin Hsieh, Bassam A Masri and 28 more

Registry-linked trialOpen access · hybridAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in European journal of epidemiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03741296 (REVISITS Trial), which is not on this map. Cited by 50 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
50citing papers in PubMed, 7 pooled it
11.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03741296 naunknown statusnot on this mapstarted 2019, after this paper: background citation

REVISITS Trial: Revision Single or Two Stage Surgery for Periprosthetic Hip Infection - a Multicentre Randomized Clinical Trial

TypeinterventionalSponsorUnity Health TorontoRan2019 to 2022Enrolled110ConditionsTotal Hip Replacement, Arthroplasty ComplicationsArmsSingle stage revision, Two-stage revision
3 · Its place in the literature

Who cites it

50 citing papers in PubMed, 7 syntheses or guidelines pooled it, 109 citations in OpenAlex.

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  17. MappingMicroorganisms · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

38 authors at 20 institutions in 7 countries.

Setor K KunutsorMusculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, Southmead Hospital, University of Bristol, Southmead Road, Bristol, BS10 5NB, UK. skk31@cantab.net.
Michael R WhitehouseMusculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, Southmead Hospital, University of Bristol, Southmead Road, Bristol, BS10 5NB, UK.
Ashley W BlomMusculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, Southmead Hospital, University of Bristol, Southmead Road, Bristol, BS10 5NB, UK.
Tim BoardWrightington, Wigan and Leigh NHS Foundation Trust, Appley Bridge, Wigan, Lancashire, WN6 9EP, UK.
Peter KayWrightington, Wigan and Leigh NHS Foundation Trust, Appley Bridge, Wigan, Lancashire, WN6 9EP, UK.
B Mike WroblewskiWrightington, Wigan and Leigh NHS Foundation Trust, Appley Bridge, Wigan, Lancashire, WN6 9EP, UK.
Valérie ZellerCentre de Référence des Infections Ostéo-Articulaires Complexes, Groupe Hospitalier Diaconesses-Croix Saint-Simon, 125, rue d'Avron, 75020, Paris, France.
Szu-Yuan ChenDepartment of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 5 Fu-Hsing Street, Kweishan, 333, Taoyuan, Taiwan.
Pang-Hsin HsiehDepartment of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 5 Fu-Hsing Street, Kweishan, 333, Taoyuan, Taiwan.
Bassam A MasriDepartment of Orthopaedics, University of British Columbia, 2775 Laurel St, Vancouver, V5Z 1M9, BC, Canada.
Amir HermanDepartment of Orthopaedics, University of British Columbia, 2775 Laurel St, Vancouver, V5Z 1M9, BC, Canada.
Jean-Yves JennyCentre for Orthopaedic and Hand Surgery, University Hospital, Strasbourg, 10 Avenue Baumann, 67400, Illkirch, France.
Ran SchwarzkopfDivision of Adult Reconstruction, Department of Orthopedics, NYU Langone Medical Center, Hospital for Joint Diseases, New York, NY, USA.
John-Paul WhittakerRobert Jones and Agnes Hunt Orthopaedic Hospital NHS Trust, Oswestry, SY10 7AG, UK.
Ben BurstonRobert Jones and Agnes Hunt Orthopaedic Hospital NHS Trust, Oswestry, SY10 7AG, UK.
Ronald HuangThe Rothman Institute of Orthopaedics, Thomas Jefferson University Hospital, 925 Chestnut Street, 5th Floor, Philadelphia, PA, 19107, USA.
Camilo RestrepoThe Rothman Institute of Orthopaedics, Thomas Jefferson University Hospital, 925 Chestnut Street, 5th Floor, Philadelphia, PA, 19107, USA.
Javad ParviziThe Rothman Institute of Orthopaedics, Thomas Jefferson University Hospital, 925 Chestnut Street, 5th Floor, Philadelphia, PA, 19107, USA.
Sergio RudelliDepartment of Orthopaedic Surgery, Santa Casa Medical School, São Paulo, Brazil.
Emerson HondaDepartment of Orthopaedic Surgery, Santa Casa Medical School, São Paulo, Brazil.
David E UipDepartment of Orthopaedic Surgery, Santa Casa Medical School, São Paulo, Brazil.
Guillem BoriBone and Joint Infectious Diseases Unit, Department of Orthopaedic and Trauma Surgery, IDIBAPS, Hospital Clinic of Barcelona, University of Barcelona, C/Villarroel 170, 08036, Barcelona, Spain.
Ernesto Muñoz-MahamudBone and Joint Infectious Diseases Unit, Department of Orthopaedic and Trauma Surgery, IDIBAPS, Hospital Clinic of Barcelona, University of Barcelona, C/Villarroel 170, 08036, Barcelona, Spain.
Elizabeth DarleySevern Pathology Infection Sciences, Pathology Sciences Building, North Bristol NHS Trust, Southmead Hospital, Westbury-on-Trym, Bristol, BS10 5ND, UK.
Alba RiberaDepartment of Infectious Diseases, IDIBELL, Hospital Universitari de Bellvitge, Feixa Llarga s/n., L'Hospitalet de Llobregat, 08907, Barcelona, Spain.
Elena CañasDepartment of Orthopaedic Surgery, IDIBELL, Hospital Universitari de Bellvitge, Feixa Llarga s/n., L'Hospitalet de Llobregat, 08907, Barcelona, Spain.
Javier CaboDepartment of Orthopaedic Surgery, IDIBELL, Hospital Universitari de Bellvitge, Feixa Llarga s/n., L'Hospitalet de Llobregat, 08907, Barcelona, Spain.
José Cordero-AmpueroCirugía Ortopédica y Traumatología, Hospital Universitario La Princesa, Océano Antártico 41, Tres Cantos, 28760, Madrid, Spain.
Maria Luisa Sorlí RedóDepartment of Infectious Diseases, Parc de Salut Mar, Passeig Marítim 25-29, E-08003, Barcelona, Spain.
Simon StrangeMusculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, Southmead Hospital, University of Bristol, Southmead Road, Bristol, BS10 5NB, UK.
Erik LenguerrandMusculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, Southmead Hospital, University of Bristol, Southmead Road, Bristol, BS10 5NB, UK.
Rachael Gooberman-HillMusculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, Southmead Hospital, University of Bristol, Southmead Road, Bristol, BS10 5NB, UK.
Jason WebbNorth Bristol NHS Trust, Southmead Hospital, Bristol, BS10 5NB, UK.
Alasdair MacGowanSevern Pathology Infection Sciences, Pathology Sciences Building, North Bristol NHS Trust, Southmead Hospital, Westbury-on-Trym, Bristol, BS10 5ND, UK.
Paul DieppeMedical School, University of Exeter, Exeter, EX1 2LU, UK.
Matthew WilsonPrincess Elizabeth Orthopaedic Centre, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK.
Andrew D BeswickMusculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, Southmead Hospital, University of Bristol, Southmead Road, Bristol, BS10 5NB, UK.
Global Infection Orthopaedic Management Collaboration
University of Bristol · GBBellvitge University Hospital · ESSouthmead Hospital · GBWrightington, Wigan and Leigh NHS Foundation Trust · GBHospital Sírio-Libanês · BRRobert Jones and Agnes Hunt Orthopaedic Hospital · GBThomas Jefferson University Hospital · USUniversity of British Columbia · CAChang Gung Memorial Hospital · TWChang Gung University · TWConsorci Institut D'Investigacions Biomediques August Pi I Sunyer · ESGroupe Hospitalier Diaconesses Croix Saint-Simon · FRHospital Universitario de La Princesa · ESNational Institute for Health Research · GBNew York University Langone Orthopedic Hospital · USNIHR Bristol Biomedical Research Centre · GBNorth Bristol NHS Trust · GBParc de Salut · ESPrincess Elizabeth Orthopaedic Centre · GBRothman Institute · US

Funding

Department of Health RP-PG-1210-12005Programme Grants for Applied Research RP-PG-1210-12005
6 · The paper itself

Abstract

One-stage and two-stage revision strategies are the two main options for treating established chronic peri-prosthetic joint infection (PJI) of the hip; however, there is uncertainty regarding which is the best treatment option. We aimed to compare the risk of re-infection between the two revision strategies using pooled individual participant data (IPD). Observational cohort studies with PJI of the hip treated exclusively by one- or two-stage revision and reporting re-infection outcomes were retrieved by searching MEDLINE, EMBASE, Web of Science, The Cochrane Library, and the WHO International Clinical Trials Registry Platform; as well as email contact with investigators. We analysed IPD of 1856 participants with PJI of the hip from 44 cohorts across four continents. The primary outcome was re-infection (recurrence of infection by the same organism(s) and/or re-infection with a new organism(s)). Hazard ratios (HRs) for re-infection were calculated using Cox proportional frailty hazards models. After a median follow-up of 3.7 years, 222 re-infections were recorded. Re-infection rates per 1000 person-years of follow-up were 16.8 (95% CI 13.6-20.7) and 32.3 (95% CI 27.3-38.3) for one-stage and two-stage strategies respectively. The age- and sex-adjusted HR of re-infection for two-stage revision was 1.70 (0.58-5.00) when compared with one-stage revision. The association remained consistently absent after further adjustment for potential confounders. The HRs did not vary importantly in clinically relevant subgroups. Analysis of pooled individual patient data suggest that a one-stage revision strategy may be as effective as a two-stage revision strategy in treating PJI of the hip.

Indexed as

AgedArthroplasty, Replacement, HipCohort StudiesFemaleHip ProsthesisHumansInfectionsMaleMiddle AgedPostoperative ComplicationsProportional Hazards ModelsProsthesis-Related InfectionsReoperationTreatment OutcomeMeta-analysisOne-stageProsthesis related infectionRe-infectionReoperationRevisionTotal hip replacementTwo-stage

Identifiers

PMID29623671
PMCPMC6153557
OpenAlexW2796384333

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.