The uncemented Avenir stem covered with hydroxyapatite in a septic environment in the revision of an infected total hip prosthesis: a report on 40 cases.

Abstract

Does the implantation of an uncemented hydroxyapatite-coated first-line stem in a septic environment during a one-stage total hip revision (THR) for periprosthetic joint infection on total hip replacement provide good results in terms of healing the infection and osteointegration of the stem ? We retrospectively reviewed 40 patients operated on for septic THR with placement of the cementless Avenir stem - between 2008 and 2018 at the Besancon University Hospital - with a minimum follow-up of 2 years necessary to define cure in the absence of infectious recurrence. Clinical outcome was assessed using the Harris, Oxford and Merle D'Aubigne scores. Osteointegration was analyzed by the Enhg radiographic score. Mean follow-up was 4.5 years (0-11). Cure of infection was achieved in 35 of 40 (87.5%). The median Harris score was 74/100, Oxford score 45/60, and Merle d'Aubigne score 15/18. Of 37 femoral stems, 36 (97%) had radiographically stable osteointegration. An age of 80 years is a risk factor for failure of septic THR with implantation of an uncemented stem in one stage. The cementless Avenir stem has its place in one-stage septic THPR. It gives good results on the healing of the infection and the integration of the stem in the context of femoral bone loss rated Paprosky 1.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This study did not receive any funding

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethics committee of Besancon University Hospital gave ethical approval for this work

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Yes

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Data Availability

All data produced in the present study are available upon reasonable request to the authors

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