Is there a role for spacer exchange in two-stage exchange arthroplasty for periprosthetic joint infection?

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Abstract

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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Kozaily, E., Chisari, E., & Parvizi, J. (2020, September 1). Is there a role for spacer exchange in two-stage exchange arthroplasty for periprosthetic joint infection? Journal of Clinical Medicine. MDPI. https://doi.org/10.3390/jcm9092901

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