We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
The use of cell salvage during second-stage reimplantation for the treatment of chronic hip periprosthetic joint infection: a retrospective cohort study.
- Authors
Liu, Zunhan; Yang, Xuetao; Zhao, En-Ze; Wan, Xufeng; Cao, Guorui; Zhou, Zongke
- Abstract
Introduction: Given the possibility of inadvertent bacterial contamination of salvaged blood, the use of cell salvage is relatively contraindicated in cases of reimplantation for chronic hip periprosthetic joint infection (PJI). However, there are no published data supporting this assertion. The purpose of the current study was to compare the reinfection rate and rate of postoperative allogeneic blood transfusion (ABT) in second-stage reimplantation for PJI with or without intraoperative cell salvage reinfusion. Materials and methods: We identified 125 patients who underwent two-stage exchange for chronic hip PJI between November 2012 and April 2019. The groups of patients who had (n = 61) and had not (n = 64) received intraoperative cell salvage reinfusion were compared with respect to the curative infection-free rate. Moreover, we compared the need for postoperative ABT and identified independent factors associated with ABT using multiple regression analysis. Results: The log-rank survival curve with an endpoint of infection eradication failure was not significantly different between the cell salvage group (98.4%, 95% CI 95.3–99.9%) and the control group (95.3%, 95% CI 90.2–99.9%) at one year (log rank, P =.330). The rates of postoperative ABT in the cell salvage group were significantly lower than those in the control group (11.5% vs 26.6%, P =.041). In multivariable models, patient age, body mass index, preoperative hemoglobin level, and intraoperative cell salvage were independent predictors of ABT exposure (P <.05). Conclusions: The use of cell salvage during reimplantation in two-stage exchange for chronic hip PJI did not appear to increase the reinfection rate, while it significantly reduced the rate of postoperative allogeneic red blood transfusion. Greater age, lower BMI, lower preoperative hemoglobin, and non-intraoperative cell salvage reinfusion were associated with higher rate of allogeneic red blood transfusion.
- Subjects
SURGICAL complication risk factors; TOTAL hip replacement; AUTOTRANSFUSION of blood; HEMOGLOBINS; CONFIDENCE intervals; INTRAOPERATIVE care; BLOOD transfusion; MULTIPLE regression analysis; LOG-rank test; AGE distribution; REINFECTION; RETROSPECTIVE studies; SURGERY; PATIENTS; INFECTION; OPERATIVE blood salvage; RISK assessment; COMPARATIVE studies; TREATMENT effectiveness; REOPERATION; DESCRIPTIVE statistics; BODY mass index; PROSTHESIS-related infections; LONGITUDINAL method; DISEASE risk factors; EVALUATION
- Publication
Journal of Orthopaedic Surgery & Research, 2022, Vol 17, Issue 1, p1
- ISSN
1749-799X
- Publication type
Article
- DOI
10.1186/s13018-022-02955-3