ArticleArchives of orthopaedic and trauma surgery2022
Single-stage total hip arthroplasty after failed fixation of proximal femoral fractures: an increased risk for periprosthetic joint infections?
Article in Archives of orthopaedic and trauma surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Comparison of complications between total hip arthroplasty following failed internal fixation and primary total hip arthroplasty for femoral neck fractures: A meta-analysis.Joint diseases and related surgery · 2025Pooled it
- Latent infections in conversion total hip arthroplasty following internal fixation of femoral neck fractures: a systematic review and meta-analysis of diagnostic methods.Archives of orthopaedic and trauma surgery · 2024Pooled it
- Revision total elbow arthroplasty for aseptic and septic nonunion of distal humerus fractures: a case series.JSES reviews, reports, and techniques · 2026Article
- Conversion total hip arthroplasty following failed proximal femoral fixation: current concepts review.Hip international : the journal of clinical and experimental research on hip pathology and therapy · 2026Review
- [One- or two-stage approach after osteosynthesis failure in proximal femur fracture-a narrative review].Orthopadie (Heidelberg, Germany) · 2026Review
- Accuracy of Preoperative Hip Aspiration in Diagnosing Infection before Conversion to Total Hip Arthroplasty after Failed Fixation for Hip Fracture: A Retrospective Study.The archives of bone and joint surgery · 2026Article
- Article
- Infectiological Outcome of Total Hip and Total Knee Arthroplasty in Post-Traumatic and Primary Osteoarthritis.Antibiotics (Basel, Switzerland) · 2024Article
- Best of Both Worlds? Fixation of Distal Femur Fractures with the Nail-Plate Construct.Orthopaedic surgery · 2023Article
- 3D reduction combined with the modified Kirschner-wire tension band for the treatment of comminuted patella fracture.Archives of orthopaedic and trauma surgery · 2023Article
- Sternal fractures in blunt trauma patients.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Conversion of failed internal fixation in proximal femur fractures using calcar-guided short-stem total hip arthroplasty.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2022Article
- Retrospective Study from a Single Center to Identify Risk Factors Associated with Reinfection in Patients Undergoing 2-Stage Revision Surgery for Periprosthetic Joint Infection.Medical science monitor : international medical journal of experimental and clinical research · 2022Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHigher complication rates have been reported for total hip arthroplasty (THA) after osteosynthesis of proximal femur fractures (PFF). This study evaluated the infection risk for conversion of internal fixation of PFF to THA by a single-staged procedure in the absence of clear infection signs.
methodsPatients undergoing a one-staged conversion to THA (2013-2018) after prior internal fixation of the proximal femur were included. Preoperative diagnostics with laboratory results, hip aspirations as well as intraoperative microbiology and sonication were assessed. Postoperative complications were recorded as well as patient demographics, duration between initial and conversion to THA, explanted osteosynthesis and implanted THA.
resultsFifty-eight patients (24 male/34 female, 62.8 ± 14.5 years) were included with a mean time of 3.8 ± 7.5 years between internal fixation and conversion to THA (45 cementless, 3 cemented, 3 hybrid and 7 hybrid inverse THAs). Preoperative mean blood level CRP was 8.36 ± 14 mg/l (reference value < 5 mg/l) and leukocyte count was 7.11 ± 1.84^3/µl (4.5-10.000^3/µl). Fifty patients had intraoperative microbiological diagnostics, with either swabs in 86.2% and/or sonication in 29.3%. Positive microbiological results were recorded in 10% (5 of 50 patients), with pathogens identified being mainly Staphylococcus. Complications after conversion occurred in 9.6% including a postoperative low-grade infection rate of 5.8% after a mean of 2.5 years.
conclusionThis study found a positive microbiological test result in 10% of a one-stage conversion of PFF fixation to THA. Moreover, we found a high infection rate (5.8%) for early postoperative periprosthetic joint infection. Interestingly, CRP has not been proven to be an adequate parameter for low-grade infections or occult colonized implants. Therefore, we recommend a comprehensive pre- and intraoperative diagnostic including hip aspiration, swabs and sonication when considering one-staged revision.
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