Exact(5)
Partial exchange revision has thus been more feasible, which may have contributed to the dramatic increase in partial 1-stage exchange revision since 2000, as shown in Figure 2.
This increase in minor partial 1-stage exchange revision could then partially explain the reported increase in revision for infection in Norway (Dale et al. 2009, Walenkamp 2009).
Recommendations for partial exchange revision of infected THAs stress the importance of a short duration of signs or symptoms of infection (less than 3 weeks) after the onset of infection (Zimmerli et al. 2004).
With any reason for re-revision as endpoint, for the period 2002 2009 and compared to 2-stage exchange revision, the risk of re-revision was 1.3 times higher for 1-stage exchange (p = 0.5), 7.4 times higher for major partial exchange (p < 0.001), and 1.9 times higher for minor partial exchange (p = 0.05) (Table 4 and Figure 5A).
Additionally, 8 of 9 patients with PJI and implant failure required of a new surgery: two-stage exchange revision was the most frequent type of surgery in 5 cases (55.5 %) followed by surgical debridement in 2 cases (22.2 %) and Girdlestone procedure in 1 case (11.1%).
Similar(55)
Such minor revisions may also be performed and reported earlier postoperatively than full exchange revisions.
These minor revisions may have different indications or a lower threshold to be performed than full exchange revisions.
Importantly, it was decided that any further operation after the primary procedure, regardless of whether the implants were exchanged (revision) or not, should be used as failure parameter.
Thus the average number of exchanges (revisions and amendments) was 76 (median, 60; range, 19 212, 95% CI, 55 96) per year and per committee, ranging from 13 exchanges for phase I studies on drugs, through 19 for studies not investigating drugs and to 45 for studies on drugs other than phase 1. Revisions were requested for 555 (57%) protocols, but only 181 (19%) required a second revision or more.
11 patients underwent a simultaneous cup exchange at revision, and 2 later cup revisions were also done.
Revisions may range from a simple polyethylene liner exchange to revision of all 3 components.
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