This paper presents a series of patients with complex periprosthetic joint infection of the knee and concomitant soft tissue defects managed with revision knee surgery and a gastrocnemius flap. We show that this flap can be safely performed by appropriately trained orthopaedic surgeons and confirmed the previous literature findings that patients presenting with this problem have high rates of persistent infection.

This study provides a comprehensive overview of a frequently used treatment strategy for chronic prosthetic joint infection of the hip and knee. Forty-seven patients met the inclusion criteria. Successful eradication was achieved in 36 of 47 cases. Multiple variables were analysed to explore their influence on the outcome of two-stage revision surgery. No variables were found to have a significant influence. Mean follow-up of over 10 years provides a good perspective of the long-term outcome.

Infection after total hip (THA) or total knee (TKA) arthroplasty can be treated by a so-called DAIR procedure within 4 weeks after surgery. However, could a DAIR be successful up to 3 months? In the Dutch Arthroplasty Register we found a re-revision rate of 8% within 4 weeks after THA and 9% re-revisions between 4 and 12 weeks. After TKA we found 9% re-revisions within 4 weeks and 17% failures after 4–12 weeks. We show no difference for DAIRs performed within 4 weeks or between 4 and 12 weeks.