Review
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Dec 18, 2020; 11(12): 559-572
Published online Dec 18, 2020. doi: 10.5312/wjo.v11.i12.559
Systematic review of single stage revision for prosthetic joint infection
Zachary C Lum, Christopher Thomas Holland, John P Meehan
Zachary C Lum, Department of Orthopaedic Surgery, Davis Medical Center, University of California, Sacramento, CA 95817, United States
Christopher Thomas Holland, John P Meehan, Department of Orthopaedics, University of California, Davis Medical Center, Sacramento, CA 95817, United States
Author contributions: Lum ZC designed and performed the research; Lum ZC and Holland CT analyzed the data; Lum ZC, Meehan JP, and Holland CT wrote and were responsible for revising the paper; Lum ZC and Meehan PJ supervised the manuscript. All authors read and approved the manuscript. 
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Christopher Thomas Holland, MD, MSc, Surgeon, Orthopaedics, University of California, Davis Medical Center, 4860 Y Street, Suite 3800, Sacramento, CA 95817, United States. ctholland@ucdavis.edu
Received: August 30, 2020
Peer-review started: August 30, 2020
First decision: October 5, 2020
Revised: October 20, 2020
Accepted: November 29, 2020
Article in press: November 29, 2020
Published online: December 18, 2020
Processing time: 105 Days and 16.8 Hours
Abstract

While advanced technology, increased medical knowledge and improved surgical technique has improved patient outcomes in total joint arthroplasty, prosthetic joint infection still remains one of the leading causes of increased healthcare costs, medical resources and societal burdens in orthopaedic care. Two stage arthroplasty revision remains the gold standard for treatment of prosthetic joint infection. Proponents of single stage revision arthroplasty for infection argue that it results in lower healthcare costs while improving patient reported functional outcomes and with equivalent success rates. Here we review the history of single stage revision arthroplasty, discuss the key principles, highlight the indications and contraindications, and review the reported outcomes with a focus on future developments of single stage revision arthroplasty for hip and knee periprosthetic joint infections.

Keywords: Prosthetic joint infection; Single stage; Revision total joint arthroplasty; Total knee arthroplasty; Infection

Core Tip: Single stage revision for periprosthetic joint infection can be a successful operation with careful selection of the patient, infecting organism and precise surgical technique. The 3 key principles of bacterial sensitivities, thorough radial debridement and delivery of local and systemic antibiotics can result in similar infection free survivorship to two stage exchange. Future developments into this technique include its practice in culture negative infections or use of cementless implants. Randomized controlled trials may help further our understanding of single stage revision compared with two stage.