Abstract

Background:Periprosthetic joint infection (PJI) is a devastating complication of joint replacement surgery. In an aging population of the developed world, the increasing numbers of hip and knee replacements will inevitably lead to increasing incidence of PJI, carrying with (it) significant patient morbidity and cost to the health care system. Two-stage exchange arthroplasty is currently the gold standard but it is associated with multiple operations, prolonged hospitalization and impaired functionality. One-stage exchange arthroplasty is similar to the two-stage procedure but the interval between removal of the prosthesis and reimplantation of a new one is only a few minutes. It has the theoretical benefits of a single anesthetic, shorter hospitalization, less cost and improved function.Methods:We reviewed the current literature regarding the outcomes of one-stage exchange arthroplasties focusing on re-infection rates and functional outcomes.Results:Current themes around the one-stage exchange procedure include the indications for the procedure, definition of re-infection, surgical techniques used to provide fixation and differences in approach for hip and knee replacements.Conclusion:The current literature on one-stage exchange procedure is promising, with comparable results to two-stage revisions for hips and knees in selected patients. However, there is a great need for a large multi-centred randomized control trial, focusing on re-infection rates and functional scores postoperatively, to provide concrete guidelines in managing this complex condition.

Highlights

  • Total hip and knee arthroplasties significantly improve pain, mobility and quality of life, periprosthetic1874-3250/16 2016 Bentham OpenOne-stage Revision for Periprosthetic Hip and Knee Joint InfectionsThe Open Orthopaedics Journal, 2016, Volume 10 647 joint infections (PJIs) can be a very serious complication of joint arthroplasty

  • resulting lack of consensus regarding its definition and diagnosis further confound the lack of high power studies to determine the optimal treatment strategy

  • The goal of successful eradication of infection while preserving functionality presents a delicate balance between I&D with retention

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Summary

Background

Periprosthetic joint infection (PJI) is a devastating complication of joint replacement surgery. In an aging population of the developed world, the increasing numbers of hip and knee replacements will inevitably lead to increasing incidence of PJI, carrying with (it) significant patient morbidity and cost to the health care system. Two-stage exchange arthroplasty is currently the gold standard but it is associated with multiple operations, prolonged hospitalization and impaired functionality. One-stage exchange arthroplasty is similar to the two-stage procedure but the interval between removal of the prosthesis and reimplantation of a new one is only a few minutes. It has the theoretical benefits of a single anesthetic, shorter hospitalization, less cost and improved function

Conclusion
INTRODUCTION
Late chronic
SUMMARY & FUTURE CONSIDERATIONS
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