Persistent Wound Drainage After Total Joint Arthroplasty: A Narrative Review

Area of Science:

• Orthopedic Surgery
• Infectious Diseases

Background:

• Persistent wound drainage is a significant complication following total joint arthroplasty (TJA).
• This complication carries risks, notably the development of periprosthetic joint infection.

Purpose of the Study:

• To review existing literature on persistent wound drainage after TJA.
• To propose a classification system and algorithmic approach for managing this complication.

Main Methods:

• Literature review of available studies on diagnosis and treatment of persistent wound drainage post-TJA.
• Development of a classification and management algorithm based on the reviewed literature.

Main Results:

• Literature on persistent wound drainage after TJA is limited, lacking evidence-based guidelines.
• Clinical signs and serological tests aid in diagnosing infection.
• Non-surgical management includes dressings and immobilization; surgical intervention (debridement, irrigation, component exchange, antibiotics) is indicated for persistent drainage (>5-7 days).

Conclusions:

• A proposed classification and algorithmic approach for managing persistent wound drainage after TJA aims to guide orthopedic surgeons.
• This guideline seeks to optimize treatment by balancing overtreatment and undertreatment.
• Prospective trials are needed to validate the proposed classification and algorithm.