One-stage Treatment of Prosthetic Joint Infection


Management of prosthetic joint infection in hip and knee arthroplasty patients is traditionally undertaken with a two-stage treatment protocol. However, this strategy carries high morbidity and cost, yet a substantial portion of patients sustain reinfection. One-stage treatment protocols have been popularized in Europe and other parts of the world but remain infrequently performed in the United States, despite equivocal efficacy with two-stage treatment based on currently available data. Herein, we describe a current one-stage treatment protocol used as part of a multicenter randomized clinical trial in the United States. Furthermore, a case example is presented of a patient with prosthetic joint infection of the hip, successfully treated with a one- stage protocol including details on revising the hip through a direct anterior approach with use of an anterior cortical window osteotomy for removal of a well-fixed femoral component. (Journal of Surgical Orthopaedic Advances 30(4):216–219, 2021)

Key words: one-stage treatment, prosthetic joint infection, double setup, direct anterior hip revision, anterior cortical window osteotomy

Cody C. Wyles, MD and Brian M. Curtin, MD