TIME INTERVAL BETWEEN FIRST AND SECOND STAGE REVISION HIP ARTHROPLASTY FOR INFECTION, THE EFFECT ON OUTCOME

The aim of revision hip arthroplasty for infection is to eradicate infection and restore function. There is, in current literature, little evidence to suggest an optimal time interval between first (excision) and second (reconstruction) stage procedures in revision hip arthroplasty. Our aim was to assess the difference in outcome, in terms of patient pain, function and satisfaction, in relation to the time interval between surgeries. A prospective analysis was made of 22 consecutive patients who underwent two-stage revision total hip replacement between 1992 and 2001. There were 12 male and 10 female patients. The mean age at the time of revision surgery was 63.5 years (range 35–83 years). The indication for surgery was infection in all cases. Patients were subdivided into two groups according to the time interval between first and second stages : Group 1 – time interval 6 months or less; Group 2 – time interval greater than 1 year. Outcome was assessed at 1 year post-operatively using change in pain and function scores and patient satisfaction scores. Pre-operative pain and function scores were similar in the two Groups. Both Groups reported a similar improvement in pain at 1 year post-operatively. The patients in Group 1 also showed an improvement in function score, however, the patients in Group 2 showed no improvement in function. All patients felt the operation to be worthwhile as reflected in the patient satisfaction scores. The results suggest that good improvements in pain can be achieved after short and longer time intervals. A longer time interval may well be associated with a poorer outcome in terms of restoring function.