Little data is available regarding complications associated with resection
arthroplasty in the treatment of hip periprosthetic joint
infection (PJI). We assessed complications during and after two-stage revision using resection
arthroplasty. In this retrospective study, 93 patients undergoing resection
arthroplasty for hip PJI were included. Patients were assigned to a
prosthesis-free interval of ≤10 weeks (group 1; 49 patients) or >10 weeks (group 2; 44 patients). The complication rates between groups were compared using the chi-squared test. The revision-free and
infection-free survival was estimated using a Kaplan-Meier survival analysis. Seventy-one patients (76%) experienced at least one local complication (overall 146 complications). Common complications were blood loss during
reimplantation (n = 25) or during explantation (n = 23),
persistent infection (n = 16), leg length discrepancy (n = 13) and
reinfection (n = 9). Patients in group 1 experienced less complications after
reimplantation (p = 0.012). With increasing severity of acetabular bone defects, higher incidence of complications (p = 0.008), periprosthetic
bone fractures (p = 0.05) and blood loss (p = 0.039) was observed. The
infection-free survival rate at 24 months was 93.9% in group 1 and 85.9% in group 2. The indication for resection
arthroplasty needs to be evaluated carefully, considering the high rate of complications and reduced mobility, particularly if longer
prosthesis-free intervals are used.