One-Stage Exchange Arthroplasty of the Infected Knee

2021 ◽  
pp. 171-178
Author(s):  
Mustafa Citak ◽  
Sophia-Marlene Busch ◽  
Christian Lausmann ◽  
Philip Linke ◽  
Thorsten Gehrke
Keyword(s):  
One Stage ◽  
Exchange Arthroplasty

scholarly journals One-Stage Exchange Arthroplasty for Fistulizing Periprosthetic Joint Infection of the Hip: An Effective Strategy

2020 ◽  
Vol 7 ◽  
Author(s):  
Simon Marmor ◽  
Younes Kerroumi ◽  
Vanina Meyssonnier ◽  
Luc Lhotellier ◽  
Antoine Mouton ◽  
...  
Keyword(s):  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Effective Strategy ◽  
One Stage ◽  
Exchange Arthroplasty

The treatment of periprosthetic joint infection: safety and efficacy of two stage versus one stage exchange arthroplasty

2020 ◽  
Vol 17 (3) ◽  
pp. 245-252 ◽  
Author(s):  
Joseph R. Palmer ◽  
Tejbir S. Pannu ◽  
Jesus M. Villa ◽  
Jorge Manrique ◽  
Aldo M. Riesgo ◽  
...  
Keyword(s):  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Stage Versus ◽  
Two Stage ◽  
Safety And Efficacy ◽  
One Stage ◽  
Exchange Arthroplasty

scholarly journals Diagnosis and management of infected arthroplasty

SICOT-J ◽  
2021 ◽  
Vol 7 ◽  
pp. 54
Author(s):  
Tejbir S. Pannu ◽  
Jesus M. Villa ◽  
Carlos A. Higuera
Keyword(s):  
Joint Infection ◽  
Treatment Options ◽  
Clinical Situation ◽  
The United States ◽  
Sinus Tract ◽  
Two Stage ◽  
International Consensus ◽  
Musculoskeletal Infection ◽  
One Stage ◽  
Exchange Arthroplasty

Periprosthetic joint infection (PJI) is one of the most dreadful complications after THA and TKA. Though prevention is of utmost importance in PJI management, the last decade has seen many remarkable developments in PJI diagnosis, including the introduction of several standardized PJI diagnostic definitions and biomarkers. Depending on the specific clinical situation, a myriad of treatment options for PJI are offered. Our review aims to summarize the pertinent information on PJI diagnosis and synthesize literature on the different treatment methods currently used in clinical practice. One of the most accepted PJI diagnostic definitions was developed by the Musculoskeletal Infection Society (MSIS) in 2011, later modified in the 2013 International Consensus Meeting (ICM). After promising results from studies, alpha-defensins and D-dimer were recently incorporated into the 2018 ICM PJI definition. The management choices for PJI include irrigation and debridement (DAIR), one-stage exchange arthroplasty, or two-stage exchange arthroplasty, to name a few. While two-stage revision has traditionally been the treatment of choice in the United States, there has been a growing body of evidence framing one-stage revision as a comparable choice. One-stage revision should be offered in patients meeting strict selection criteria: no sinus tract, proper soft tissue available for wound closure, appropriate bone stock, a favorable identifiable organism with encouraging antibiotic sensitivities (for cement and oral suppression later), and robust immunological status. DAIR can be considered in case of early infections with sensitive infecting organisms. Patients with multiple unsuccessful revisions or those who refuse further surgical intervention for PJI can be offered antibiotic suppression. If nothing seems to work, salvage procedures (resection arthroplasty and arthrodesis) are available as a last resort. Further research is encouraged to improve on diagnostic capabilities and develop evidence on the best treatment of choice for PJI.

What Are the Indications for One-Stage Versus Two-Stage Exchange Arthroplasty in Management of the Infected Total Ankle Arthroplasty (TAA)?

2019 ◽  
Vol 40 (1_suppl) ◽  
pp. 55S-58S
Author(s):  
Kent Ellington ◽  
Thomas B. Bemenderfer
Keyword(s):  
Patient Population ◽  
Acute Infection ◽  
Stage Versus ◽  
Patient Factors ◽  
Two Stage ◽  
Level Of Evidence ◽  
Ankle Arthroplasty ◽  
One Stage ◽  
Exchange Arthroplasty ◽  
Strong Consensus

Recommendation: Two-stage exchange arthroplasty is recommended in the majority of cases following infected TAA. One-stage arthroplasty is only indicated in a limited patient population with acute infection, preoperatively identified low-virulence organisms, and low-risk patient factors. Level of Evidence: Consensus. Delegate Vote: Agree: 92%, Disagree: 8%, Abstain: 0% (Super Majority, Strong Consensus).

scholarly journals An Alternative One-Stage Exchange Arthroplasty Technique: For the Chronic Infected Total Hip

Cureus ◽  
2020 ◽  
Author(s):  
Keith Kotecki ◽  
Victor Hoang ◽  
Daniel LeCavalier ◽  
Michael Bradford
Keyword(s):  
Total Hip ◽  
One Stage ◽  
Exchange Arthroplasty

scholarly journals Minocycline Combined with Vancomycin for the Treatment of Methicillin-Resistant Coagulase-Negative Staphylococcal Prosthetic Joint Infection Managed with Exchange Arthroplasty

2020 ◽  
Vol 5 (3) ◽  
pp. 110-117
Author(s):  
Géraldine Bart ◽  
Valérie Zeller ◽  
Younes Kerroumi ◽  
Beate Heym ◽  
Vanina Meyssonnier ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Joint Infection ◽  
Survival Rates ◽  
Methicillin Resistant ◽  
One Stage ◽  
Joint Infections ◽  
Exchange Arthroplasty ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections

Abstract. Introduction: Treatment of methicillin-resistant (MR) staphylococcal prosthetic joint infections (PJIs) remains a matter of discussion, with vancomycin-rifampin combination therapy being the preferred treatment for DAIR and one-stage exchange arthroplasty strategies. This study analyzes the outcomes of patients with chronic methicillin-resistant coagulase-negative staphylococcal PJIs treated with vancomycin-minocycline combination therapy.Methods: This prospective, single center cohort study included all chronic MR coagulase-negative staphylococcal PJIs (01/2004-12/2014) treated with exchange arthroplasty and at least 4 weeks of minocycline-vancomycin. The following endpoints were considered: reinfection including relapse (same microorganism) and a new infection (different microorganism) and PJI-related deaths. Their outcomes were compared with PJIs treated with rifampin-vancomycin during the same period.Results: Thirty-four patients (median age, 69 years) with 22 hip and 12 knee arthroplasty infections were included. Sixteen (47%) had previously been managed in another center. Median vancomycin MIC of strains was 3 mg/L. Nineteen underwent one-stage, 15 two-stage exchange arthroplasty. After a median [IQR] follow-up of 43 [26-68] months, 2 patients relapsed and 6 developed a new PJI. Compared to 36 rifampin-vancomycin treated PJIs, relapse- or reinfection-free survival rates didn't differ, but more new infections developed in the minocycline group (6 vs 3; P 0.3).Conclusions: Minocycline-vancomycin combination therapy for chronic MR coagulase-negative staphylococcal PJIs seems to be an interesting therapeutic alternative.

scholarly journals One-stage Exchange Arthroplasty for Periprosthetic Hip and Knee Joint Infections

2016 ◽  
Vol 10 (1) ◽  
pp. 646-653 ◽  
Author(s):  
Manny Nguyen ◽  
Mohamed Sukeik ◽  
Akos Zahar ◽  
Ikram Nizam ◽  
Fares Sami Haddad
Keyword(s):  
Current Literature ◽  
Joint Infection ◽  
Surgical Techniques ◽  
Infection Rates ◽  
Two Stage ◽  
Joint Replacement Surgery ◽  
One Stage ◽  
Exchange Arthroplasty ◽  
Functional Scores ◽  
Knee Replacements

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.

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