Abstract
Two stage revision for infection is considered the gold standard with a success rate of 80 to 90%. Overall functional outcomes of these patients tends to be overlooked. There is a trend towards single stage revision to improve functional outcomes.
We examined the functional scores of 2 stage revision for total hip arthroplasty (THR) and total knee arthroplasty (TKR) revision over nine years.
Seventy-two revisions were identified: 30 THR and 42 TKR. Two year survivorship was 96% in THR revision and 88% TKR revision. Five year survival was 83% and 84% respectively. 50 patients (without recurrence of infection) had recorded functional scores at a minimum of 1 year.
The mean Harris-hip scores (HHS) of 21 THR were 75 prior to developing symptoms of infection. Once infected, the mean score fell to 46. At 1 year post revision it returned to 77. At 3 years HHS of 78 (12 patients) and at 5 yrs 62 (3 patients).
The mean knee society scores (KSS) of 29 TKR were 66 prior to developing symptoms of infection. Once infected, the mean score fell to 34. At 1 year post revision it returned to 73. At 3 years KSS of 76 (16 patients) and at 5 years 62 (10 patients).
We conclude that functional scores of two-stage revisions of infected THR and TKR return to pre-morbid levels within a year of completing the second stage. Although single stage revision may have a quicker return to function, by 1 year, a staged revision has comparable results.
