Xiangxuan Wang1, Wenming Zhang2. 1. Department of Orthopedics, the First Affiliated Hospital of Fujian Medical University, Fuzhou Fujian, 350000, P.R.China. 2. Department of Orthopedics, the First Affiliated Hospital of Fujian Medical University, Fuzhou Fujian, 350000, P.R.China.zhangwm0591@163.com.
Abstract
OBJECTIVE: To summarize the research progress of two-stage revision for periprosthetic joint infection (PJI) after hip and knee arthroplasties. METHODS: The related literature on two-stage revision for PJI was summarized, and the new progress in the choice of spacers, systemic antibiotic therapy, and risk factors were analyzed. RESULTS: Two-stage revision is a common way to treat infection after hip and knee arthroplasties. The types of spacers used in the one-stage operation are diverse and each has its own advantages and disadvantages. Non-articular spacers are mainly used for the patients with poor soft tissue conditions around the joints and severe bone defects. But the joint mobility is not good after the placement of the spacer. Articular spacers can restore the affected joint movement after operation, which is beneficial to the joint mobility after two-stage operation. The use of antibiotics is an indispensable part of the treatment process, and the effectiveness of short-term antibiotic treatment is similar to long-term treatment. Identifying the relevant risk factors that influence the prognosis of the two-stage revision can help preoperative management and reduce the recurrence rate of infection. CONCLUSION: There are still controversies about the choice of spacers and systemic antibiotic therapy during the two-stage revision and treatment of PJI. The factors affecting the prognosis of the two-stage revision need to be explored and the further high-quality research is needed.
OBJECTIVE: To summarize the research progress of two-stage revision for periprosthetic joint infection (PJI) after hip and knee arthroplasties. METHODS: The related literature on two-stage revision for PJI was summarized, and the new progress in the choice of spacers, systemic antibiotic therapy, and risk factors were analyzed. RESULTS: Two-stage revision is a common way to treat infection after hip and knee arthroplasties. The types of spacers used in the one-stage operation are diverse and each has its own advantages and disadvantages. Non-articular spacers are mainly used for the patients with poor soft tissue conditions around the joints and severe bone defects. But the joint mobility is not good after the placement of the spacer. Articular spacers can restore the affected joint movement after operation, which is beneficial to the joint mobility after two-stage operation. The use of antibiotics is an indispensable part of the treatment process, and the effectiveness of short-term antibiotic treatment is similar to long-term treatment. Identifying the relevant risk factors that influence the prognosis of the two-stage revision can help preoperative management and reduce the recurrence rate of infection. CONCLUSION: There are still controversies about the choice of spacers and systemic antibiotic therapy during the two-stage revision and treatment of PJI. The factors affecting the prognosis of the two-stage revision need to be explored and the further high-quality research is needed.
Authors: N Benito; M Franco; A Ribera; A Soriano; D Rodriguez-Pardo; L Sorlí; G Fresco; M Fernández-Sampedro; M Dolores Del Toro; L Guío; E Sánchez-Rivas; A Bahamonde; M Riera; J Esteban; J M Baraia-Etxaburu; J Martínez-Alvarez; A Jover-Sáenz; C Dueñas; A Ramos; B Sobrino; G Euba; L Morata; C Pigrau; P Coll; I Mur; J Ariza Journal: Clin Microbiol Infect Date: 2016-05-13 Impact factor: 8.067