Prosthetic retention: Treatment options

Abstract

Infection after total joint arthroplasty (TJA) remains a difficult complication to treat. The rate of infection ranges from 0.5 to 4 % after primary and revision hip and knee arthroplasty. Several demographic studies indicate that more infections occur after these procedures and infection is the most common reason for TKA failure and third most common reason for THA failure. Prevention remains the key to minimizing the risk of infection; however, little evidence-based literature exists to establish the optimal approach. Several options are available to treat deep periprosthetic infections. The timing of the infection as it relates to surgery and the onset of symptoms are critical in determining treatment success. Prosthetic retention is an attractive low-morbidity option for the treatment of the infected total TJA. Options include antibiotic suppression, arthroscopic irrigation and debridement and open irrigation and debridement with polyethylene exchange. The overall indications for prosthetic retention options are limited. The overall success as reported in more recent literature for any prosthetic retention options brings into question its current role in the treatment of the infected TJA.