Periprosthetic Joint Infection Treatment in Total Hip and Knee Arthroplasty

The cumulative incidence of periarticular joint infection is about 1.2%, and there are multiple ways to surgically manage these patients. Arthroscopy is not recommended because of poor outcomes of high infection recurrence. Open debridement and irrigation shows a success rate up to 80%, and this technique should only be considered during the very early stages of infection. For definitive treatment, one-stage or two-stage exchange arthroplasty is recommended, and the success rate after single-stage revision and two-stage revision is about 93% and 86%, respectively. However, comparative studies have not shown significant difference in the success rate of infection control comparing one-stage and two-stage surgery. Static or articulating spacers are implanted in two-stage exchange arthroplasty, and articulating spacers seem to show some advantage with regard to range of motion. Cement abrasion is considered a problem with articulating spacer placement, and there has been no significant difference in clinical outcomes between spacers reported yet.