ReviewArthroplasty (London, England)2023
Interval between two-stage exchanges: what is optimal and how do you know?
Review in Arthroplasty (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
What it found
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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.
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Who cites it
19 citing papers in PubMed.
- Preoperative predictors of spacer retention and mortality in two-stage revision for infected total hip arthroplasties: a single-center experience of 90 patients.Arthroplasty (London, England) · 2026Article
- Short-interval total femur replacement for infected distal femoral reconstruction.Journal of surgical case reports · 2026Article
- Application of a new lavage-suction technique in managing chronic periprosthetic joint infection : Short running title: new lavage-section technique for PJI.Journal of orthopaedic surgery and research · 2025Article
- Review
- Impact of introducing custom-made articulating spacers: A retrospective cohort study on two protocols for two-stage hip revision.World journal of orthopedics · 2025Article
- The Influence of Antibiotic-Loaded Bone Cement Spacer Type on Outcomes of the First Stage of a Revision Total Hip Arthroplasty.Antibiotics (Basel, Switzerland) · 2025Article
- Periprosthetic joint infection after arthroplasty: advances and future prospects.Journal of orthopaedic surgery and research · 2025Review
- 'Hybrid' spacers in two-stage total hip arthroplasty revision: surgical technique, clinical and radiographic outcomes.Archives of orthopaedic and trauma surgery · 2025Article
- Synergistic antibacterial drug elution from UHMWPE for load-bearing implants.Journal of materials chemistry. B · 2025Article
- Periprosthetic Joint Infection (PJI).The archives of bone and joint surgery · 2025Review
- Periprosthetic joint infections - a scoping review.Innovative surgical sciences · 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
- Evaluation of Gentamicin Release of PMMA Cements Using Different Methods: HPLC, Elution and Inhibition Zone Testing.Antibiotics (Basel, Switzerland) · 2024Article
- Impact of Manual Addition of Vancomycin to Polymethylmethacrylate (PMMA) Cements.Antibiotics (Basel, Switzerland) · 2024Article
- Editorial: Management of PJI/SSI after joint arthroplasty.Arthroplasty (London, England) · 2024Article
- Is there sufficient evidence to support the use of antibiotic holiday just before the second stage of an infected total hip or knee arthroplasty revision surgery?World journal of orthopedics · 2024Article
- Upcoming evidence in clinical practice of two-stage revision arthroplasty for prosthetic joint infection.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2024Review
- Rotational Thromboelastometry as a Diagnostic Tool for Persistent Infection in Two-Stage Exchange Arthroplasty.Journal of clinical medicine · 2024Article
- A Modified Technique for Two-Stage Revision in Knee PJI Treatment.Journal of clinical medicine · 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
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTwo-stage exchange arthroplasty remains the most popular option for the treatment of chronic periprosthetic joint infection (PJI). Determining infection eradication and optimal timing of reimplantation can be challenging. Information to allow for a truly informed evidence-based decision is scarce.
methodsWe conducted a critical review of available evidence on the presently available tests to help determine timing of reimplantation.
resultsSerology is traditionally used to follow up patients after the first stage. Despite tradition mandates waiting for normal inflammatory markers, there is actually no evidence that they correlate with persistent infection. The role of synovial fluid investigation between stages is also explored. Cultures lack sensitivity and neither differential leukocyte counts nor alternative biomarkers have proven to be accurate in identifying persistent infection with a spacer in situ. We also examined the evidence regarding the optimal time interval between resection and reimplantation and whether there is evidence to support the implementation of a two week "antibiotic holiday" prior to proceeding with reimplantation. Finally, wound healing and other important factors in this setting will be discussed.
conclusionCurrently there are no accurate metrics to aid in the decision on the optimal timing for reimplantation. Decision must therefore rely on the resolution of clinical signs and down trending serological and synovial markers.
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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.