ArticleBone & joint open2021
Three-stage revision arthroplasty for the treatment of fungal periprosthetic joint infection: outcome analysis of a novel treatment algorithm : a prospective study.
Article in Bone & joint open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- The heavy burden and treatment challenges of fungal periprosthetic joint infection: a systematic review of 489 joints.BMC musculoskeletal disorders · 2024Pooled it
- Fungal Periprosthetic Joint Infection: A Systematic Review and Meta-analysis of Treatment Approaches and Clinical Outcomes.Open forum infectious diseases · 2026Review
- The proportion of chronic periprosthetic joint infection patients withJournal of bone and joint infection · 2026Article
- A One- or Two-Stage Revision of Fungal Prosthetic Joint Infection: A Review of Current Knowledge, Pitfalls and Recommendations.Antibiotics (Basel, Switzerland) · 2025Review
- Outcome Predictors ofOpen forum infectious diseases · 2025Article
- Fungal Prosthetic Joint Infection: A Case Series and Review of the Literature.Infectious diseases and therapy · 2024Article
- Periprosthetic bacterial and fugal infection after total knee arthroplasty with one-stage debridement: a case report.Journal of medical case reports · 2024Article
- The fate of fungal periprosthetic joint infection after total knee arthroplasty.International orthopaedics · 2023Article
- Epidemiology of Fungal Periprosthetic Joint Infection: A Systematic Review of the Literature.Microorganisms · 2022Review
- Fungal Periprosthetic Hip Joint Infections.Diagnostics (Basel, Switzerland) · 2022Review
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsFungal periprosthetic joint infections (fPJIs) are rare complications, constituting only 1% of all PJIs. Neither a uniform definition for fPJI has been established, nor a standardized treatment regimen. Compared to bacterial PJI, there is little evidence for fPJI in the literature with divergent results. Hence, we implemented a novel treatment algorithm based on three-stage revision arthroplasty, with local and systemic antifungal therapy to optimize treatment for fPJI.
methodsFrom 2015 to 2018, a total of 18 patients with fPJI were included in a prospective, single-centre study (DKRS-ID 00020409). The diagnosis of PJI is based on the European Bone and Joint Infection Society definition of periprosthetic joint infections. The baseline parameters (age, sex, and BMI) and additional data (previous surgeries, pathogen spectrum, and Charlson Comorbidity Index) were recorded. A therapy protocol with three-stage revision, including a scheduled spacer exchange, was implemented. Systemic antifungal medication was administered throughout the entire treatment period and continued for six months after reimplantation. A minimum follow-up of 24 months was defined.
resultsEradication of infection was achieved in 16 out of 18 patients (88.8%), with a mean follow-up of 35 months (25 to 54). Mixed bacterial and fungal infections were present in seven cases (39%). The interval period, defined as the period of time from explantation to reimplantation, was 119 days (55 to 202). In five patients, a salvage procedure was performed (three cementless modular knee arthrodesis, and two Girdlestone procedures).
conclusionTherapy for fPJI is complex, with low cure rates according to the literature. No uniform treatment recommendations presently exist for fPJI. Three-stage revision arthroplasty with prolonged systemic antifungal therapy showed promising results. Cite this article:
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