ArticleBMC musculoskeletal disorders2026
Differential impact of single interim spacer exchanges on survival outcomes in two-stage exchange arthroplasty for PJIs: a comparative analysis with minimum 5-year follow-up.
Article in BMC musculoskeletal disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
backgroundManaging periprosthetic joint infections (PJIs) in orthopedic surgery is particularly challenging, especially with two-stage exchange arthroplasty. This study examines the impact of different single spacer exchange strategies on reimplantation success, reinfection risk, and survival outcomes.
methodsA retrospective review was conducted on 650 patients who underwent two-stage exchange arthroplasty for PJIs from 2000 to 2017. After exclusions, 94 patients with a single spacer exchange were identified. We used univariate and multivariate Cox regression analyses and propensity score matching to evaluate reimplantation success, as defined by Delphi-based criteria.
resultsAmong the 94 patients, 77 underwent reimplantation surgery post-single spacer exchange. Of these, 29 had strategic spacer exchanges, and 48 had unplanned exchanges due to mechanical problems (22) or persistent infections (26). Unplanned exchanges due to persistent infections and a Charlson Comorbidity Index (CCI) over seven were significant predictors of poor reimplantation success and higher reinfection risk (p < 0.05). Patients transferred from other hospitals, those with the same pathogen causing persistent PJI as in the first stage, and those with the same pathogen identified in unexpected positive intraoperative cultures (UPICs) had increased reinfection risks (p < 0.05). Survival analysis indicated that unplanned exchanges due to persistent PJI significantly elevated failure rates (p < 0.05).
conclusionsWhile previous studies have suggested poor outcomes associated with spacer exchanges, our findings indicate that this is not universally the case. However, unplanned spacer exchanges, particularly those necessitated by persistent infections, result in significantly worse outcomes compared to other strategies. Therefore, unplanned exchanges require meticulous management to improve patient outcomes and reduce the risk of reinfection. 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.