Abstract
Although it does offer some advantages, the one-staged exchange in periprosthetic
joint infection (PJI) remains rare in the orthopedic world. Besides the reduced number
of surgical interventions for the patients, it is usually associated with a decreased
in-hospital stay and quicker mobilization. Furthermore, it might be the more cost-effective
approach and allows for a reduced duration of postoperative systemic antibiotics,
usually less than 14 days. Technically, the presence of a positive culture by preoperative
aspiration or biopsy and respective antibiogram is mandatory. A cemented implant fixation
using specified topic antibiotics, based on the antibiogram, is treatment of choice
for one-staged procedures. The overall success is based on the well-defined and detailed
intrahospital infrastructure, including a meticulous preoperative planning, joint
aspiration regime, and aggressive intraoperative surgical approach. This article describes
the one-staged exchange in infected PJI of the knee joint, which has been established
40 years ago in the HELIOS ENDO-Klinik Hamburg, Germany.
Keywords
periprosthetic joint infection - one-staged exchange - antibiotic - PJI
