Long-term outcome of prosthetic joint infections treated with two-stage revision


prosthetic joint infection ; two-stage revision ; antibiotic treatment ; spacer sonication

Published online: May 29 2020

Giuliana Carrega 1, Giorgetta Casalino -Finocchio 1, Luca Cavagnaro 2, Lamberto Felli 2, Giovanni Riccio 1, Giorgio Burastero 1

1 Department of Infectious Diseases and Septic Orhopedics (Malattie Infettive e Ortopedia Settica), Santa Maria di Misericordia Hospital, Albenga, Savona, Italy.
2 Department of Orthopedics, University of Genoa, Viale Benedetto XV Genoa, Italy


Long-term evaluation of prosthetic joint infection treated with two-stage revision.

Retrospective analysis of 102 periprosthetic infections treated with two-stage revision from 2010 to 2012 in Albenga hospital, Italy. During the second stage, samples for microbiological tests were collected. Failure was defined as a persistence of infection during the second stage or as a relapse during follow-up.

102 cases (55 hip, 47 knee) were analyzed. Patients were evaluated for a median of 44 months. 8/102 (8%) had positive cultures at replacement. These patients were treated with long-term antibiotic treatment and in 3/8 (38%) infection was cured. 9 patients were loss to follow-up or died, 6 patients (6%) had a relapse a median of 16,3 months from replanting. Risk factors significantly related to failures were diabetes and infection due to methicillin-resistant staphylococci.

Two stage revision requires continued follow up.

Screening for infection at replacement suggests prolonged antibiotic treatment.