Two-Stage Exchange Arthroplasty for Periprosthetic Joint Infection: The Rate and Reason for the Attrition After the First Stage

Wang, Qiaojie; Goswami, Karan; Kuo, Feng-Chih; Xu, Chi; Tan, Timothy L.; Parvızı, Javad

doi:10.1016/j.arth.2019.06.021

Cited by 67 publications

(44 citation statements)

References 34 publications

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“…In this context, the reported success rates for two-stage exchange protocol range between 65% and 96% in the literature. [ 18 , 19 ] The success rate (92.9%) from this study is in accordance with the previous literature.…”

Section: Discussionsupporting

confidence: 91%

“…In a recent article by Wang et al,[ 19 ] reimplantation rate after two-stage exchange arthroplasty was retrospectively evaluated. Among 616 patients (237 hips, 379 knees), 111 (18%) did not receive reimplantation with a minimum follow-up of one year.…”

Section: Discussionmentioning

confidence: 99%

“…Our results showed lower rates of reimplantation failure than one of the larger series from the literature. [ 19 ]…”

Section: Discussionmentioning

confidence: 99%

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Low-dose vancomycin-loaded cement spacer for two-stage revision of infected total hip arthroplasty

et al. 2020

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Low-dose vancomycin-loaded cement spacer for two-stage revision of infected total hip arthroplasty

et al. 2020

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“…In fact, Gomez et al [ 57 ] reported that 17% of patients in their series did not receive reimplantation in the course of a two-stage exchange. Similarly, Wang et al [ 58 ] reported no reimplantation in 18% (n = 111/616) of the patients undergoing an intended two-stage exchange, at a minimum 1 year of follow-up. Of the 111 patients who did not receive reimplantation, 26.1% had spacer retention based on a shared decision with the surgeon, 20.7% had a salvage procedure, and half the patients (53.2%) were judged medically unfit for reimplantation thus having their spacer retained.…”

Section: Spacer Exchangementioning

confidence: 94%

Is There a Role for Spacer Exchange in Two-Stage Exchange Arthroplasty for Periprosthetic Joint Infection?

Kozaily

Chisari

Parvızı

2020

JCM

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Periprosthetic joint infection (PJI) continues to be one of the most serious complications after hip and knee arthroplasty. The choice of surgical treatment depends on a multitude of factors like chronicity of infection, host factors, and institutional or surgeon experience. Two-stage exchange remains one of the most commonly used technique for chronic PJI in the United States of America. The intended two-stage revision may involve an additional interim procedure where the initial antibiotic cement spacer is removed and a new spacer is inserted. Mostly, the rationale behind spacer exchange is an additional load of local antibiotics before proceeding to reimplantation. There is no conclusive evidence whether a spacer exchange confers additional benefits, yet it delays reimplantation and exposes already fragile patients to the risks and morbidity of an additional surgery.

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“…In THA, the most common reason for early failure is instability and dislocation 20 . More recently, mechanically assisted crevice corrosion has been appreciated to result in head‐neck taper corrosion and adverse local tissue reaction 21,22 .…”

Section: Introductionmentioning

confidence: 99%

New materials for hip and knee joint replacement: What's hip and what's in kneed?

Mihalko

Haider

Kurtz

et al. 2020

Journal Orthopaedic Research

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Over the last three decades there have been significant advancements in the knee and hip replacement technology that has been driven by an issue in the past concerning adverse local tissue reactions, aseptic and septic loosening. The implants and the materials we utilize have improved over the last two decades and in knee and hip replacement there has been a decrease in the failures attributed to wear and osteolysis. Despite these advancements there are still issues with patient satisfaction and early revisions due to septic and aseptic loosening in knee replacement patients. This article reviews the state of current implant material technology in hip and knee replacement surgery, discusses some of the unmet needs we have in biomaterials, and reviews some of the current biomaterials and technology that may be able to solve the most common issues in the knee and hip replacement surgery.

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Two-Stage Exchange Arthroplasty for Periprosthetic Joint Infection: The Rate and Reason for the Attrition After the First Stage

Cited by 67 publications

References 34 publications

Low-dose vancomycin-loaded cement spacer for two-stage revision of infected total hip arthroplasty

Low-dose vancomycin-loaded cement spacer for two-stage revision of infected total hip arthroplasty

Is There a Role for Spacer Exchange in Two-Stage Exchange Arthroplasty for Periprosthetic Joint Infection?

New materials for hip and knee joint replacement: What's hip and what's in kneed?

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