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Two-Stage Revision Arthroplasty for Periprosthetic Knee Infection

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Infection in Knee Replacement

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Abstract

Two-stage revision is the most commonly used procedure for prosthetic joint infection treatment. It consists of removing all foreign materials from the joint, making an extensive debridement of periarticular tissues and inserting a static or articulating spacer in the joint. This surgical procedure is followed by antibiotic therapy for an extended period. Finally, reimplantation is made when the infection is eradicated. The two-stage revision procedure is mostly used for patients with an unclear causative pathogen, bacteria unsusceptible to available antibiotics, patients with signs of systemic sepsis, and patients with extensive comorbidities. Patients may be candidates for static spacers if they have significant bone loss, ligamentous or muscle injuries, periprosthetic fracture, or soft tissue defects. Limited evidences are available on the superiority of two-stage over one-stage revision in terms of success, eradication of infection, or patient satisfaction. Future studies are necessary to delineate the superiority of a one- or two-stage revision approach.

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Authors and Affiliations

  1. Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, Rome, Trigoria, Italy

    Umile Giuseppe Longo, Sergio De Salvatore, Vincenzo Candela, Giovanna Stelitano, Calogero Di Naro, Carlo Casciaro, Laura Risi Ambrogioni & Vincenzo Denaro

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  1. Umile Giuseppe Longo
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  2. Sergio De Salvatore
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Correspondence to Umile Giuseppe Longo .

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Editors and Affiliations

  1. Università Campus Bio-Medico di Roma, Rome, Italy

    Umile Giuseppe Longo

  2. Arthroplasty & Sports Medicine, Nicolaas Institute of Constructive Orthopedic Research, Jakarta, Indonesia

    Nicolaas C. Budhiparama

  3. Département de Chirurgie Orthopédiq, Hôpital de la Croix-Rousse, Lyon Cedex 04, France

    Sébastien Lustig

  4. Department of Orthopaedics and Traumatology, Center of Joint Replacement, Medical Director of the University Hospital, University of Brandenburg an der Havel, Brandenburg, Germany

    Roland Becker

  5. Clínica do Dragao - Espregueira-Mendes, Braga, Portugal

    João Espregueira-Mendes

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Longo, U.G. et al. (2022). Two-Stage Revision Arthroplasty for Periprosthetic Knee Infection. In: Longo, U.G., Budhiparama, N.C., Lustig, S., Becker, R., Espregueira-Mendes, J. (eds) Infection in Knee Replacement. Springer, Cham. https://doi.org/10.1007/978-3-030-81553-0_17

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  • DOI: https://doi.org/10.1007/978-3-030-81553-0_17

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