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

Summary Does the implantation of an uncemented hydroxyapatite-coated first-line stem in a septic environment during a one-stage total hip arthroplasty revision (THAR) for periprosthetic joint infection on total hip arthroplasty provide good results in terms of healing the infection and osteointegration of the stem ? We retrospectively reviewed 40 patients operated on for septic THAR with placement of the cementless Avenir® stem - between 2008 and 2018 at the Besançon 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’Aubigné 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’Aubigné 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 THAR with implantation of an uncemented stem in one stage. The cementless Avenir® stem has its place in one-stage septic THAR. 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.