H M L Mühlhofer1, J Schauwecker2, I J Banke2, R von Eisenhart-Rothe2. 1. Klinik und Poliklinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland. heinrich.muehlhofer@mri.tum.de. 2. Klinik und Poliklinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland.
Abstract
BACKGROUND: The treatment of prosthetic joint infection (PJI) is truly challenging. Patients with infected arthroplasty face physical and psychosocial problems. Furthermore, treatment costs represent a tremendous socioeconomic burden. AIM: This article presents an overview of the preoperative diagnosis of PJI and one- or two-stage endoprosthetic exchange options. METHOD: A selective literature search was performed focusing on diagnostics and innovative surgical treatment concepts in PJI. RESULTS: The identification of the underlying pathogen is still the main focus in the diagnosis of PJI. State-of-the-art therapy for PJI with mature biofilm consists of implant removal with one- or two-stage exchange arthroplasty. One-stage exchange offers lower morbidity and improved functional outcome, whereas a two-stage procedure is, according to current knowledge, more favourable in terms of infection control. The novel short-term two-stage exchange regimen combines the advantages of both possibilities. DISCUSSION: Prosthetic joint infection represents a significant challenge for the othopaedic surgeon. Novel treatment options can help to improve outcome and lower the costs to the health care system.
BACKGROUND: The treatment of prosthetic joint infection (PJI) is truly challenging. Patients with infected arthroplasty face physical and psychosocial problems. Furthermore, treatment costs represent a tremendous socioeconomic burden. AIM: This article presents an overview of the preoperative diagnosis of PJI and one- or two-stage endoprosthetic exchange options. METHOD: A selective literature search was performed focusing on diagnostics and innovative surgical treatment concepts in PJI. RESULTS: The identification of the underlying pathogen is still the main focus in the diagnosis of PJI. State-of-the-art therapy for PJI with mature biofilm consists of implant removal with one- or two-stage exchange arthroplasty. One-stage exchange offers lower morbidity and improved functional outcome, whereas a two-stage procedure is, according to current knowledge, more favourable in terms of infection control. The novel short-term two-stage exchange regimen combines the advantages of both possibilities. DISCUSSION: Prosthetic joint infection represents a significant challenge for the othopaedic surgeon. Novel treatment options can help to improve outcome and lower the costs to the health care system.
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