Staphylococcus aureus prosthetic joint infection treated with prosthesis removal and delayed reimplantation arthroplasty

Claudia M. Brandt, Mary C T Duffy, Elie F. Berbari, Arlen D. Hanssen, James M. Steckelberg, Douglas R. Osmon

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Abstract

Objective: To estimate in patients with Staphylococcus aureus prosthetic joint infection after total hip arthroplasty (THA) or total knee arthroplasty (TKA) the microorganism-specific cumulative probability of treatment failure after prosthesis removal and delayed reimplantation arthroplasty. Patients and Methods: All patients with S aureus THA or TKA infection, according to a strict case definition, who were treated with prosthesis removal and delayed reimplantation arthroplasty at Mayo Clinic Rochester between 1980 and 1991 were identified. The study group comprised patients who were free of infection at the time of reimplantation arthroplasty. This cohort was followed up until treatment failure, infection with another organism, prosthesis removal, death, or loss to follow-up occurred. The Kaplan-Meier survival method was used to estimate the cumulative probability of treatment failure. Results: Among 120 S aureus prosthetic joint infections treated with prosthesis removal during the study period, 38 episodes (22 THA, 16 TKA) in 36 patients met the study inclusion criteria. After a median of 7.4 years (range, 0.9 year-16.4 years) of follow-up, treatment failure occurred in 1 (2.6%) of 38 episodes 1.4 years after reimplantation arthroplasty. The 5- year cumulative probability of treatment failure was 2.8% (95% confidence interval, 0%-8.2%). Conclusions: These data suggest that prosthesis removal and delayed reimplantation arthroplasty is an effective treatment to limit the recurrence of S aureus prosthetic joint infection, provided there is no evidence of infection at the time of reimplantation arthroplasty.

Original languageEnglish (US)
Pages (from-to)553-558
Number of pages6
JournalMayo Clinic Proceedings
Volume74
Issue number6
StatePublished - 1999

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Replantation
Arthroplasty
Prostheses and Implants
Staphylococcus aureus
Joints
Treatment Failure
Infection
Knee Replacement Arthroplasties
Hip
Confidence Intervals
Recurrence
Survival

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Brandt, C. M., Duffy, M. C. T., Berbari, E. F., Hanssen, A. D., Steckelberg, J. M., & Osmon, D. R. (1999). Staphylococcus aureus prosthetic joint infection treated with prosthesis removal and delayed reimplantation arthroplasty. Mayo Clinic Proceedings, 74(6), 553-558.

Staphylococcus aureus prosthetic joint infection treated with prosthesis removal and delayed reimplantation arthroplasty. / Brandt, Claudia M.; Duffy, Mary C T; Berbari, Elie F.; Hanssen, Arlen D.; Steckelberg, James M.; Osmon, Douglas R.

In: Mayo Clinic Proceedings, Vol. 74, No. 6, 1999, p. 553-558.

Research output: Contribution to journalArticle

Brandt, CM, Duffy, MCT, Berbari, EF, Hanssen, AD, Steckelberg, JM & Osmon, DR 1999, 'Staphylococcus aureus prosthetic joint infection treated with prosthesis removal and delayed reimplantation arthroplasty', Mayo Clinic Proceedings, vol. 74, no. 6, pp. 553-558.
Brandt, Claudia M. ; Duffy, Mary C T ; Berbari, Elie F. ; Hanssen, Arlen D. ; Steckelberg, James M. ; Osmon, Douglas R. / Staphylococcus aureus prosthetic joint infection treated with prosthesis removal and delayed reimplantation arthroplasty. In: Mayo Clinic Proceedings. 1999 ; Vol. 74, No. 6. pp. 553-558.
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AU - Steckelberg, James M.

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N2 - Objective: To estimate in patients with Staphylococcus aureus prosthetic joint infection after total hip arthroplasty (THA) or total knee arthroplasty (TKA) the microorganism-specific cumulative probability of treatment failure after prosthesis removal and delayed reimplantation arthroplasty. Patients and Methods: All patients with S aureus THA or TKA infection, according to a strict case definition, who were treated with prosthesis removal and delayed reimplantation arthroplasty at Mayo Clinic Rochester between 1980 and 1991 were identified. The study group comprised patients who were free of infection at the time of reimplantation arthroplasty. This cohort was followed up until treatment failure, infection with another organism, prosthesis removal, death, or loss to follow-up occurred. The Kaplan-Meier survival method was used to estimate the cumulative probability of treatment failure. Results: Among 120 S aureus prosthetic joint infections treated with prosthesis removal during the study period, 38 episodes (22 THA, 16 TKA) in 36 patients met the study inclusion criteria. After a median of 7.4 years (range, 0.9 year-16.4 years) of follow-up, treatment failure occurred in 1 (2.6%) of 38 episodes 1.4 years after reimplantation arthroplasty. The 5- year cumulative probability of treatment failure was 2.8% (95% confidence interval, 0%-8.2%). Conclusions: These data suggest that prosthesis removal and delayed reimplantation arthroplasty is an effective treatment to limit the recurrence of S aureus prosthetic joint infection, provided there is no evidence of infection at the time of reimplantation arthroplasty.

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