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results of each case series are controversial, and the performance of single-stage compared to two-stage exchange remains unclear. In order to clarify this question, we performed a systematic review of the available literature comparing single- and double-stage
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several different surgical methods being applied ( Fig. 2 ). These include debridement, antibiotics and implant retention (DAIR), one or two-stage exchange arthroplasty procedure or, when these treatments are inadequate, salvage procedures such as
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, two-stage revision, arthrodesis, chronic antibiotic administration and even amputation. The outcomes of some of these options are described below. Debridement Debridement, irrigation and multiple deep samples may be proposed in cases of acute
School of Health Sciences, Faculty of Medicine, University of Thessalia, Larissa, Greece
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Pandit H . One-stage versus two-stage exchange arthroplasty for infected total knee arthroplasty: a systematic review . Knee Surg Sports Traumatol Arthrosc 2016 ; 24 : 3106 – 3114 . 14. Pangaud C Ollivier M Argenson
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://doi.org/10.1007/s11999-011-2102-9 ) 5 Chuang CA Lee SH Chang CH Hu CC Shih HN Ueng SWN & Chang Y . Application of structural allogenous bone graft in two-stage exchange arthroplasty for knee periprosthetic joint infection: a case control
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destruction is significant, a two-stage primary joint arthroplasty with bony cut and spacer may be considered to first sterilize the joint and subsequently reconstruct it. However, some authors suggest that a single-stage approach is feasible when the
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osteolysis around the proximal part of the stem. b) One stage exchange with uncemented components. The defects were filled with antibiotic impregnated bone Osteomycin V. Sonification of explanted material revealed growth of two strains of Staph. epidermidis
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polyethylene exchange is an attractive option in treating peri-prosthetic infections because it involves a single operation. This procedure may reduce the potential morbidity associated with a two-stage re-implantation procedure, such as loss of bone stock
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Leeds Institute of Rheumatic Musculoskeletal Medicine (LIRMM), Chapel Allerton Hospital, Leeds, UK
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Leeds Institute of Rheumatic Musculoskeletal Medicine (LIRMM), Chapel Allerton Hospital, Leeds, UK
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Leeds Institute of Rheumatic Musculoskeletal Medicine (LIRMM), Chapel Allerton Hospital, Leeds, UK
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of 68 patients undergoing two-stage exchange arthroplasty reported comparison between static (handmade) or dynamic StageOne® injection-moulded knee (Zimmer Biomet) spacers ( 69 ). Patients in the dynamic group had a significantly better range of
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We believe that an attempt to irrigate and debride with polyethylene exchange presents little harm to patients. However, it is controversial whether DAIR may diminish the eradication potential of a future one- or two-stage revision surgery. Sherrell
