Articles | Volume 11, issue 4
https://doi.org/10.5194/jbji-11-513-2026
https://doi.org/10.5194/jbji-11-513-2026
Original full-length article
 | 
19 Aug 2026
Original full-length article |  | 19 Aug 2026

Reinfection and complication rates in two-stage revision for chronic hip periprosthetic joint infections using the direct anterior approach

Sebastian Simon, Jennyfer A. Mitterer, Bernhard J. H. Frank, Stephanie Huber, Sujeesh Sebastian, Susana Gardete-Hartmann, and Jochen G. Hofstaetter

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Cited articles

Abuelnour, M., McNamee, C., Rafi, A. B., Hohlbein, W., Keogh, P., and Cashman, J.: Mid-term to long-term outcome and risk factors for failure of 158 hips with two-stage revision for periprosthetic hip joint infection, J. Bone Joint Infect., 10, 15–24, https://doi.org/10.5194/jbji-10-15-2025, 2025. 
Acuña, A. J., Do, M. T., Samuel, L. T., Grits, D., Otero, J. E., and Kamath, A. F.: Periprosthetic joint infection rates across primary total hip arthroplasty surgical approaches: a systematic review and meta-analysis of 653,633 procedures, Arch. Orthop. Trauma Surg., 142, 2965–2977, https://doi.org/10.1007/s00402-021-04186-3, 2021. 
Aichmair, A., Frank, B. J. H., Singer, G., Simon, S., Dominkus, M., and Hofstaetter, J. G.: Differential microbiological spectrum and resistance pattern in periprosthetic hip joint infections: a matched-cohort analysis comparing direct anterior versus lateral approach, BMC Musculoskelet. Disord., 23, 72, https://doi.org/10.1186/s12891-022-05037-x, 2022. 
Australian Orthopaedic Association National Joint Replacement Registry: Australian Orthopaedic Association National Joint Replacement Registry, 211ff pp., https://doi.org/10.25310/GLOL7776, 2024. 
Carli, A. V., Poitras, S., Clohisy, J. C., and Beaulé, P. E.: Variation in Use of Postoperative Precautions and Equipment Following Total Hip Arthroplasty: A Survey of the AAHKS and CAS Membership, J. Arthroplasty, 33, 3201–3205, https://doi.org/10.1016/j.arth.2018.05.043, 2018. 
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Short summary
Two-stage septic revision was evaluated in 36 / 8476 (0.4 %) patients after primary total hip arthroplasty (THA) using the direct anterior approach (DAA). Infection-free survival was 77.8 % after a median follow-up of 6 years. Spacer-related complications occurred in 5.6 %. Revision for dislocation after reimplantation occurred in 8.3 %. Two-stage septic revision using the DAA shows reinfection rates comparable to other approaches, with low rates of spacer dislocation and postoperative dislocation after reimplantation.
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