%0 Journal Article %T Outcome of Two-Stage Revision Total Hip and Knee Arthroplasty as a Salvage Procedure for Deep Infection of Peri-Articular Fracture Fixation: Propensity Score-Matched Study %J The Archives of Bone and Joint Surgery %I Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association %Z 2345-4644 %A Van Den Kieboom, Janna %A Tirumala, Venkatsaiakhil %A Klemt, Christian %A Young-Min, Kwon %D 2022 %\ 07/01/2022 %V 10 %N 7 %P 576-584 %! Outcome of Two-Stage Revision Total Hip and Knee Arthroplasty as a Salvage Procedure for Deep Infection of Peri-Articular Fracture Fixation: Propensity Score-Matched Study %K Deep infection, Open reduction internal fixation, Periprosthetic joint infection %K Salvage procedure, Total joint arthroplasty %R 10.22038/abjs.2022.51393.2541 %X Background: Failed open reduction internal fixation (ORIF) of peri-articular fractures due to deep infection is associatedwith decreased functional outcomes and increased mortality rates. Two-stage revision total joint arthroplasty (TJA) isoften needed as a salvage procedure. The aim of this study was to evaluate the outcome of two-stage revision totalhip and knee arthroplasty as a salvage procedure for the treatment of deep infection of peri-articular fracture fixation.Methods: Using propensity score-matching, a total of 120 patients was evaluated: 1) 40 consecutive patients weretreated with planned salvage two-stage revision for the treatment of deep peri-articular infection, and 2) a controlgroup of 80 patients who underwent two-stage revision for periprosthetic joint infection (PJI) after non-IF TJA. Aninfection occurred after a fracture of the acetabulum (27.5%), femoral neck (22.5%), intertrochanteric femur (15.0%),subtrochanteric femur (5.0%), femoral shaft (7.5%), distal femur (5.0%), and tibia (15.0%).Results: At an average follow up of 4.5 years (range, 1.0-25.8), the overall failure rate was 42.5% for the IF groupcompared to 21.3% for the non-ORIF group (P=0.03). There was a significantly higher reinfection rate for the IF groupcompared to the non-IF group (35.0% vs. 11.3%, p=0.005). Tissue cultures for the IF patients demonstrated significantlyhigher polymicrobial growth (30.0% vs. 11.3%, P=0.01) and methicillin-resistant Staphylococcus aureus (20.0% vs.7.5%, P=0.04).Conclusion: Salvage two-stage revision arthroplasty for infected IF of peri-articular fractures was associated withpoor outcome. The overall post-operative complications after salvage two-stage revision for infected IF of peri-articularfractures was high with 35% reinfection rates associated with the presence of mixed and resistant pathogens.Level of evidence: III %U https://abjs.mums.ac.ir/article_19667_f2af7fc1c8e97811bc71c2b0e1eee21b.pdf