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

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 remai...

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Bibliographic Details
Published inJournal of clinical medicine Vol. 9; no. 9; p. 2901
Main Authors Kozaily, Elie, Chisari, Emanuele, Parvizi, Javad
Format Journal Article
LanguageEnglish
Published Basel MDPI AG 08.09.2020
MDPI
Subjects
Antibiotics
Cement
Clinical medicine
Debridement
Fractures
Infections
Joint replacement surgery
Joint surgery
Pathogens
Prostheses
prosthetic joint infection
Review
spacer
spacer exchange
Surgeons
total hip arthroplasty
total knee arthroplasty
Transplants & implants
two stage exchange
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Summary: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.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-3
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ObjectType-Review-1
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm9092901