CHARACTERISTIC OF PATIENTS WITH PJI OF HIP JOINT AND MEDIUM-TERM EFFICIENCY OF TREATMENT BASED ON VREDENS REGISTER
The study of periprosthetic joint infection (PJI) significantly complicates the multifactorial nature of the problem. At RSRI of TO n.a. R. R. Vreden task was solved by creating a register of PJI in the area of the hip joint (Hip) in order to accumulate a large number of patients with this pathology.Analysis of the treatment of 710 patients with Hip PJI in the period from 2006 to 2015. showed a continuous annual increase in the absolute number of infectious complications after primary and revision Hip arthroplasty (AP). Most patients (70.8%) underwent surgery with the implantation of a cement spacer, surgical treatment with implant retention was performed in 9.2% of patients, partial replacement of implant components in 8%, resection arthroplasty in 1.9%. The success of operations ranged from 53.2% when the spacer was reimplanted, to 84.2% when retention endoprosthesis with the replacement of the modular components. The success of the first stage of the two-stage procedure in patients with chronic PJI was 67.5%. The success of the second stage was higher in the group of patients with a previous primary (95.3%) or noninfection revision AP (88.7%) compared with previous infectious revisions (71.9%). Moreover, repeated interventions were required in 31.7% - 26.1% of patients who had a history of infectious or “clean” revisions, respectively. It was found that failures of the treatment significantly increase the risk of further relapses of PJI and form a group of patients with a recurrent form of chronic PJI, which subsequently require the complete removal of the endoprosthesis and the implementation of resection arthroplasty. The presented results indicate the need to keep registers of patients with PJI, with the accumulation of a large block of data on the patient's condition, the nature of surgical interventions, the characteristics of the infectious process, will make it possible to conduct a serious analysis of the treatment results, factors affecting its outcome, and therefore, will allow developing new treatment of relevant patients and evaluate their effectiveness in representative groups.