SynthesisKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2016
One-stage versus two-stage exchange arthroplasty for infected total knee arthroplasty: a systematic review.
Synthesis in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
57 citing papers in PubMed, 2 syntheses or guidelines pooled it, 139 citations in OpenAlex.
- The role of the gastrocnemius flap in implant retention strategies for acute periprosthetic joint infection following total knee arthroplasty: a systematic review.Archives of orthopaedic and trauma surgery · 2026Pooled it
- Systematic review and meta-analysis of single-stage vs two-stage revision for periprosthetic joint infection: a call for a prospective randomized trial.BMC musculoskeletal disorders · 2024Pooled it
- Use of a Bioresorbable Antibacterial Coating (DACAntibiotics (Basel, Switzerland) · 2026Article
- Functional outcomes of one-stage arthroplasty for native septic knee arthritis: a matched case-control study versus primary osteoarthritis.Frontiers in cellular and infection microbiology · 2026Article
- One-Stage Primary Total Knee Arthroplasty as the Treatment of Acute Septic Arthritis of the Native Osteoarthritic Knee: Report of 3 Cases and Review of Literature.Arthroplasty today · 2025Article
- Animal Models of Orthopedic Implant-Associated Infections and Revisions.ACS biomaterials science & engineering · 2025Review
- No difference in failure between static, articulating, and prosthetic low-friction spacers for periprosthetic joint infection of total knee arthroplasty.Journal of bone and joint infection · 2025Article
- Two-stage total joint replacement for hip or knee septic arthritis: post-traumatic etiology and difficult-to-treat infections predict poor outcomes.Archives of orthopaedic and trauma surgery · 2024Article
- What Are the Research Highlights of Periprosthetic Joint Infections From the 100 Most Cited Studies?Arthroplasty today · 2024Article
- Review of recent advances in the diagnosis and management of periprosthetic joint infection after total knee arthroplasty part 2: single-stage or two-stage surgical technique?Journal of orthopaedic surgery and research · 2024Review
- Periprosthetic Joint Infections of the Knee-Comparison of Different Treatment Algorithms.Journal of clinical medicine · 2024Article
- Systematic review and meta-analysis of single-stage versus two-stage revision for periprosthetic joint infection after knee arthroplasty: a call for a randomised trial.EFORT open reviews · 2024Article
- Debridement, Antibiotic Pearls, and Retention of the Implant (DAPRI) in the Treatment of Early Periprosthetic Knee Joint Infections: A Literature Review.Healthcare (Basel, Switzerland) · 2024Review
- A Meta-Analysis of Success Rates of One-Stage Versus Two-Stage Revisions in Knee Prosthetic Joint Infections.Cureus · 2024Review
- Do one-stage indications predict success following two-stage arthroplasty for chronic periprosthetic joint infection?Journal of bone and joint infection · 2024Article
- Two-Stage Treatment of Chronic Periprosthetic Knee Infections With the Use of Gentamicin-Articulated Spacers: Success Rate and Predictors of Failure at the Minimum Seven-Year Follow-Up.Arthroplasty today · 2023Article
- Routine use of antibiotic-laden bone cement in total knee arthroplasty is a cost-effective practice in the single-payer healthcare system.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Enough is enough: salvage procedures in severe periprosthetic joint infection.Arthroplasty (London, England) · 2023Review
- Antibiotic Prophylaxis in One-Stage Revision of Septic Total Knee Arthroplasty: A Scoping Review.Antibiotics (Basel, Switzerland) · 2023Article
- Survival, functional outcome and satisfaction of first revision total knee arthroplasty at a mean eleven-year follow-up.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeInfection complicating total knee arthroplasty (TKA) has serious implications. Traditionally the debate on whether one- or two-stage exchange arthroplasty is the optimum management of infected TKA has favoured two-stage procedures; however, a paradigm shift in opinion is emerging. This study aimed to establish whether current evidence supports one-stage revision for managing infected TKA based on reinfection rates and functional outcomes post-surgery.
methodsMEDLINE/PubMed and CENTRAL databases were reviewed for studies that compared one- and two-stage exchange arthroplasty TKA in more than ten patients with a minimum 2-year follow-up.
resultsFrom an initial sample of 796, five cohort studies with a total of 231 patients (46 single-stage/185 two-stage; median patient age 66 years, range 61-71 years) met inclusion criteria. Overall, there were no significant differences in risk of reinfection following one- or two-stage exchange arthroplasty (OR -0.06, 95 % confidence interval -0.13, 0.01). Subgroup analysis revealed that in studies published since 2000, one-stage procedures have a significantly lower reinfection rate. One study investigated functional outcomes and reported that one-stage surgery was associated with superior functional outcomes. Scarcity of data, inconsistent study designs, surgical technique and antibiotic regime disparities limit recommendations that can be made.
conclusionRecent studies suggest one-stage exchange arthroplasty may provide superior outcomes, including lower reinfection rates and superior function, in select patients. Clinically, for some patients, one-stage exchange arthroplasty may represent optimum treatment; however, patient selection criteria and key components of surgical and post-operative anti-microbial management remain to be defined. LEVEL OF EVIDENCE: III.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.