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Journal of Bone and Joint Infection An open-access journal of the European Bone and Joint Infection Society and the MusculoSkeletal Infection Society
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Volume 1, issue 1
J. Bone Joint Infect., 1, 1–6, 2016
© Author(s) 2016. This work is distributed under
the Creative Commons Attribution 4.0 License.
J. Bone Joint Infect., 1, 1–6, 2016
© Author(s) 2016. This work is distributed under
the Creative Commons Attribution 4.0 License.

Original full-length article 20 Jan 2016

Original full-length article | 20 Jan 2016

Prosthetic Joint Infection: Report on the One versus Two-stage Exchange EBJIS Survey

Pedro Santos Leite, Sérgio Figueiredo, and Ricardo Sousa Pedro Santos Leite et al.
  • Department of Orthopaedics, Centro Hospitalar do Porto - Hospital de Santo António, Porto, Portugal.

Keywords: Prosthetic Joint Infection, One-stage Exchange, Two-stage Exchange.

Abstract. Background: Prosthetic Joint Infection (PJI) is one of the most challenging problems in orthopaedic surgery and musculoskeletal infections specifically. Some very important controversies remain and strong evidence-based recommendations are still lacking in many clinical aspects. Therefore, an undisputed methodology of treatment does not exist yet and there are many different valid approaches.

Purposes: To draw a picture of the different practice patterns around Europe and understand the motivations of the European Bone & Joint Infection Society (EBJIS) members in choosing between one- or two-stage revision surgery in treating chronic PJI.

Methods: The participants of the 34th EBJIS Annual Meeting were surveyed through an online questionnaire. The survey assessed the main philosophy in the treatment of chronic PJI, personal and institutional information as well as the importance of different factors in choosing two-stage or one-stage procedures.

Results: One hundred and forty-three participants responded to the survey, including a significant group of skilful orthopaedic surgeons with large experience in treating musculoskeletal infections. Primarily two-stage was the most common philosophy regrading treatment of chronic PJI (60.1%), followed by two-stage or one-stage accordingly (34,8%) and primarily one-stage (5,1%). Significant soft tissue compromise, failure of previous revision surgery attempts, highly resistant or unclear infective microorganism(s) preoperatively and patient presenting with sepsis or immunosuppression, were considered the more relevant factors in choosing two-stage instead one-stage procedures.

Interpretation: Treatment of chronic PJI is challenging and demanding. An open dialogue to share the different experiences and a collective effort to plan a major multicentre research in order to establish standardized protocols are essential.

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