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One-stage exchange: it all began here.

T Gehrke1, A Zahar, D Kendoff

  • 1Helios Endo Klinik Hamburg, Holstenstr.2, 22767 Hamburg, Germany.

The Bone & Joint Journal
|November 5, 2013
PubMed
Summary
This summary is machine-generated.

One-stage exchange surgery for prosthetic joint infection (PJI) is effective, offering advantages over two-stage procedures. This approach requires meticulous pre-, peri-, and post-operative management for successful outcomes in PJI treatment.

Keywords:
antibiotic cementendo clinicjoint aspirationone staged exchangeperiprosthetic infection

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Area of Science:

  • Orthopedic Surgery
  • Infectious Diseases
  • Biomaterials Science

Background:

  • Prosthetic joint infection (PJI) treatment historically involves staged procedures.
  • The Endo-Klinik has utilized one-stage exchange for PJI in over 85% of cases since the 1970s.
  • Current literature lacks definitive evidence favoring two-stage over one-stage PJI exchange.

Purpose of the Study:

  • To evaluate the efficacy and methodology of one-stage exchange for prosthetic joint infection (PJI).
  • To highlight the advantages of a single-stage surgical approach for PJI.
  • To detail the critical pre-, peri-, and post-operative steps for successful one-stage PJI management.

Main Methods:

  • Detailed description of the one-stage exchange procedure for PJI.
  • Emphasis on pre-operative joint aspiration for bacterial identification and antibiogram.
  • Use of antibiotic-loaded bone cement tailored to specific bacterial sensitivities.
  • Complete removal of infected hardware and aggressive debridement of infected tissues and bone.

Main Results:

  • One-stage exchange potentially reduces operative procedures, antibiotic exposure, and hospitalization time.
  • Successful PJI management relies on precise bacterial identification and targeted antibiotic elution.
  • Meticulous surgical technique and post-operative care are crucial for favorable outcomes.

Conclusions:

  • A cemented one-stage exchange is a viable and potentially advantageous option for prosthetic joint infection (PJI) treatment.
  • Successful one-stage PJI exchange necessitates strict adherence to diagnostic and surgical protocols.
  • This approach offers benefits including reduced patient burden and healthcare resource utilization.