Evidence map›Paper›PMID 41479478›Full record

ReviewCureus2025

A Comparison of 1.5-Stage and Two-Stage Revisions for Prosthetic Joint Infection in Total Hip and Knee Arthroplasty: A Meta-Analysis of Outcomes.

Abdelrahman Ibrahim, Khadija Khamdan, Salman Sadiq, Ahmed Lyeeq, Nikhil Narayanswamy, Abu Saeed

Abstract readReview
In one paragraph

Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Abdelrahman IbrahimTrauma and Orthopaedics, Princess Royal Hospital NHS Trust, Telford, GBR.
Khadija KhamdanTrauma and Orthopaedics, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, GBR.
Salman SadiqTrauma and Orthopaedics, Russells Hall Hospital, Dudley, GBR.
Ahmed LyeeqTrauma and Orthopaedics, Princess Royal Hospital NHS Trust, Telford, GBR.
Nikhil NarayanswamyTrauma and Orthopaedics, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, GBR.
Abu SaeedTrauma and Orthopaedics, Worcestershire Acute Hospitals Trust, Worcester, GBR.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Prosthetic joint infection (PJI) is a devastating complication of total hip and knee arthroplasty. Whilst two-stage revision has long been considered the gold standard treatment, the 1.5-stage revision has emerged as a viable alternative. However, the optimal surgical strategy remains a subject of debate. The aim of this meta-analysis was to evaluate the comparative outcomes of 1.5-stage versus two-stage revision for PJI. A systematic search of electronic data sources and bibliographic reference lists was conducted. All studies reporting comparative outcomes of 1.5-stage versus two-stage revision were included, and their risk of bias was assessed. Reinfection, failure of infection eradication, aseptic loosening, overall complications, readmission, and periprosthetic fracture were the evaluated outcome parameters. All comparative studies reporting on patients who underwent either a 1.5-stage or a two-stage revision were included in the final analysis. The 1.5-stage revision was associated with a significantly lower rate of reinfection (odds ratio (OR): 0.62; 95% confidence interval (CI) 0.40-0.96, p = 0.03) but a significantly higher rate of aseptic loosening (OR: 6.12; 95% CI 1.09-34.22, p = 0.04) when compared with the two-stage revision. No significant difference was found in the rates of infection eradication (OR: 1.35; 95% CI 0.80-2.27, p = 0.26), overall complications, readmission, dislocations, or periprosthetic fracture between the two groups. A subgroup analysis for knee PJI was consistent with the main analysis for reinfection. The meta-analysis of the best available evidence indicates that a 1.5-stage revision for PJI is associated with a lower rate of reinfection but a higher risk of aseptic loosening. High-quality randomized controlled trials are needed to definitively establish the optimal surgical strategy for managing PJI.

Indexed as

1.5-stage revisionmeta-analysisprosthetic joint infection (pji)tka (total knee arthoplasty)total hip arthroplasty (tha)two-stage revision arthroplasty

Identifiers

PMID41479478
PMCPMC12754828

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Registered trials

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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.