New trial for prosthetic hip joint infection

June 14, 2017
New trial for prosthetic hip joint infection
Credit: University of Bristol

The first ever randomised trial to investigate why some patients develop infections after their hip or knee replacement surgery, and which type of surgical revision treatment is best is being run by the University of Bristol and members of the public are being asked to consider taking part.

Periprosthetic joint infection (PJI) affects approximately one per cent of patients following (THR) and often results in severe physical and emotional suffering. Current treatment options include the removal of damaged or dead tissue, antibiotics and implant retention; revising (re-doing) the joint replacement; removal of the joint; and amputation. Revision surgery can be done as either a one-stage or two-stage operation. Both types of surgery are well established in the NHS and appear to result in similar rates of re-infection, but little is known about the impact of these treatments from the patient's perspective.

The NIHR-funded INFORM (Infection – Orthopaedic Management) trial compares one-stage with two-stage revision for hip PJI and is co-ordinated by the University's Musculoskeletal Research Unit, based at Southmead Hospital. The trial's primary focus is on patient reported outcomes: pain, stiffness, function and wellbeing in the long-term.

The trial also compares the cost-effectiveness, complications and re-infection rates between these surgical interventions. Finally, an interview study explores patients' and surgeons' experiences, including their views about trial participation and randomisation.

Credit: University of Bristol

The trial has recruited over 80 patients with PJI of the hip, from 14 orthopaedic hospitals in England and Wales and six hospitals in Sweden.

Ashley Blom, Professor of Orthopaedic Surgery in the School of Clinical Sciences and Joint Head of the Musculoskeletal Research Unit (MRU), said: "Over 160,000 primary hip or knee replacements were carried out in England, Wales and Northern Ireland in 2016. About one person in 100 develops a bacterial infection at their new, artificial joint. Patients with infected joint replacements have described the experience as 'devastating' and 'associated with unbearable suffering'. If untreated, these infections can result in severe pain, persistent dislocation and death. It is important that we establish which form of treatment is best from a patient's perspective.

"Patients tell us that pain, function and long-term wellbeing are what is most important to them and that these are more important outcomes than those measured in previous non-randomised studies, such as re-infection. We hope the results of the trial will benefit patients in the future."

The findings will also help clinicians and NHS managers by enabling the comparison of these key interventions in terms of patients' complication rates, health and social resource use and their overall cost-effectiveness.

Explore further: Obesity increases risk of complications after shoulder joint replacement surgery

Related Stories

Obesity increases risk of complications after shoulder joint replacement surgery

June 8, 2017
For patients undergoing shoulder joint replacement surgery (arthroplasty), higher body mass index is linked to increased complications—including the need for "revision" surgery, reports a study in the June 7 issue of The ...

Medication to treat anxiety, depression may reduce hip, knee replacement revision risk

March 14, 2017
Patients who take selective serotonin reuptake inhibitors (SSRIs), commonly prescribed medications used to treat anxiety and depression, may experience a reduced risk of revision surgery following total hip (THR) or total ...

Knee replacement not an 'easy solution' for obese patients

October 24, 2012
Obese patients have a greater risk of complications following total knee replacement surgery, including post-surgical infections, according to a new literature review recently published in the Journal of Bone and Joint Surgery ...

Complications challenge rheumatoid arthritis patients after joint replacement surgery

November 28, 2012
In the first systemic review of evidence assessing complications following total joint arthroplasty, patients with rheumatoid arthritis (RA) were found to have an increased risk for hip dislocation after hip replacement surgery ...

Infection is the leading cause of failed prosthetic knee joints

March 12, 2014
The number of total knee replacement (TKR) procedures continues to climb, as does the number of revision total knee replacement (RTKR) surgeries. In the study, "The Epidemiology of Revision Total Knee Arthroplasty in the ...

Partial knee replacement safer than total knee replacement

July 7, 2014
Partial knee replacement surgery is safer than total knee replacement, according to a new study published in The Lancet today.

Recommended for you

Children best placed to explain facts of surgery to patients, say experts

December 13, 2017
Getting children to design patient information leaflets may improve patient understanding before they have surgery, finds an article in the Christmas issue of The BMJ.

Drug may help surgical patients stop opioids sooner

December 13, 2017
(HealthDay)—Opioid painkillers after surgery can be the first step toward addiction for some patients. But a common drug might cut the amount of narcotics that patients need, a new study finds.

Burn victim saved by skin grafts from identical twin (Update)

November 23, 2017
A man doomed to die after suffering burns across 95 percent of his body was saved by skin transplants from his identical twin in a world-first operation, French doctors said Thursday.

Is a common shoulder surgery useless?

November 21, 2017
(HealthDay)—New research casts doubt on the true effectiveness of a common type of surgery used to ease shoulder pain.

Study shows electric bandages can fight biofilm infection, antimicrobial resistance

November 6, 2017
Researchers at The Ohio State University Wexner Medical Center have shown - for the first time - that special bandages using weak electric fields to disrupt bacterial biofilm infection can prevent infections, combat antibiotic ...

Obesity increases incidence, severity, costs of knee dislocations

November 3, 2017
A new study of more than 19,000 knee dislocation cases in the U.S. between 2000 and 2012 provides a painful indication of how the nation's obesity epidemic is changing the risk, severity and cost of a traumatic injury.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.