Surgical management of periprosthetic joint infection: one-stage exchange.
Although it does offer some advantages, the one-staged exchange in periprosthetic joint infection (PJI) remains rare in the orthopedic world. Besides the reduced number of surgical interventions for the patients, it is usually associated with a decreased in-hospital stay and quicker mobilization. Furthermore, it might be the more cost-effective approach and allows for a reduced duration of postoperative systemic antibiotics, usually less than 14 days. Technically, the presence of a positive culture by preoperative aspiration or biopsy and respective antibiogram is mandatory. A cemented implant fixation using specified topic antibiotics, based on the antibiogram, is treatment of choice for one-staged procedures. The overall success is based on the well-defined and detailed intrahospital infrastructure, including a meticulous preoperative planning, joint aspiration regime, and aggressive intraoperative surgical approach. This article describes the one-staged exchange in infected PJI of the knee joint, which has been established 40 years ago in the HELIOS ENDO-Klinik Hamburg, Germany.
Department of Orthopaedic Surgery, HELIOS ENDO-Klinik Hamburg, Hamburg, Germany.
Daniel
D
Kendoff
Department of Orthopaedic Surgery, HELIOS ENDO-Klinik Hamburg, Hamburg, Germany.
Thorsten
T
Gehrke
D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D006801:Humans; D007719:Knee Joint / Q000382:microbiology / Q000601:surgery*; D010347:Patient Care Planning; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000601:surgery* / Q000628:therapy
D000900:Anti-Bacterial Agents