Should single- or two-stage revision surgery be used for the management of an infected total knee replacement? A critical review of the literature

Abstract

Introduction A post-operative periprosthetic infection of total knee replacement (TKR) is one of the most devastating complications for a patient to endure after surgery and is a challenge for the orthopaedic surgeon to treat. In this paper, we present the current evidence to support a single-stage revision of a TKR for periprosthetic infection and compare the outcome with that of a two-stage revision procedure. In addition, we also outline the methods of diagnosis used to identify a periprosthetic infection of a TKR. Conclusion The current evidence-based surgical options to manage periprosthetic infection do not offer a 100% guarantee of eradication of the infection. As to whether a single- or a two-stage procedure should be undertaken needs to be personalized to each patient and their circumstances.