INFORM

Clinical and cost effectiveness of single stage compared with two stage revision for hip prosthetic joint infection (INFORM): pragmatic, parallel group, open label, randomised controlled trial.

Blom AW, Lenguerrand E, Strange S, et al. BMJ (Clinical research ed.) 2022 · PMID 36316046 · doi:10.1136/bmj-2022-071281

Question

Is single-stage revision as effective as two-stage revision for prosthetic joint infection of the hip?

Design

Pragmatic parallel-group open-label RCT in UK and Swedish hospitals.

Patients

Adults with prosthetic joint infection of the hip needing revision surgery.

Intervention

Single-stage revision

Comparison

Two-stage revision

Primary outcome

WOMAC score at 18 months

Key result

There was no significant difference in WOMAC at 18 months; single-stage patients had better function early after surgery, and single-stage revision was less costly.

Limitations

Relatively small sample; not powered for re-infection as the primary outcome; open label.

Impact on practice

Supports single-stage revision as a reasonable option for hip PJI in suitable patients, rather than two-stage being the automatic default.