Articles | Volume 10, issue 3
https://doi.org/10.5194/jbji-10-185-2025
https://doi.org/10.5194/jbji-10-185-2025
Original full-length article
 | 
02 Jun 2025
Original full-length article |  | 02 Jun 2025

One- versus two-stage septic hip and knee revision surgery: a comparative cohort outcome study with short- to mid-term follow-up

Michelle M. J. Jacobs, Petra J. C. Heesterbeek, Karin Veerman, and Jon H. M. Goosen

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Higher 1-year risk of implant removal for culture-positive than for culture-negative DAIR patients following 359 primary hip or knee arthroplasties
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Cited articles

Budin, M., Abuljadail, S., Traverso, G., Ekhtiari, S., Gehrke, T., Sommer, R., and Citak, M.: Comparison of Patient-Reported Outcomes Measures and Quality-Adjusted Life Years Following One- and Two-Stage Septic Knee Exchange, Antibiotics (Basel), 11, 1602, https://doi.org/10.3390/antibiotics11111602, 2022. 
Diaz-Ledezma, C., Higuera, C. A., and Parvizi, J.: Success after treatment of periprosthetic joint infection: a Delphi-based international multidisciplinary consensus, Clin. Orthop. Relat. R., 471, 2374–2382, https://doi.org/10.1007/s11999-013-2866-1, 2013. 
Goud, A. L., Harlianto, N. I., Ezzafzafi, S., Veltman, E. S., Bekkers, J. E. J., and van der Wal, B. C. H.: Reinfection rates after one- and two-stage revision surgery for hip and knee arthroplasty: a systematic review and meta-analysis, Arch. Orthop. Traum. Su., 143, 829–838, https://doi.org/10.1007/s00402-021-04190-7, 2023. 
Haddad, F. S., Sukeik, M., and Alazzawi, S.: Is single-stage revision according to a strict protocol effective in treatment of chronic knee arthroplasty infections?, Clin. Orthop. Relat. R., 473, 8–14, https://doi.org/10.1007/s11999-014-3721-8, 2015. 
Izakovicova, P., Borens, O., and Trampuz, A.: Periprosthetic joint infection: current concepts and outlook, EFORT open reviews, 4, 482–494, https://doi.org/10.1302/2058-5241.4.180092, 2019. 
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Short summary
We compared the outcomes of one-stage and two-stage revision surgeries for periprosthetic joint infections of the knee and hip joints. Patients in both groups had similar reinfection rates and functional recovery, but two-stage hip patients experienced more complications, partly due to the temporary use of cement spacers. Our findings suggest that one-stage revision may be a viable alternative to two-stage revision, potentially reducing complications without increasing reinfection risk.
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