Published online Oct 18, 2019. doi: 10.5312/wjo.v10.i10.348
Peer-review started: May 20, 2019
First decision: July 31, 2019
Revised: August 14, 2019
Accepted: September 4, 2019
Article in press: September 4, 2019
Published online: October 18, 2019
Periprosthetic joint infections (PJIs) are frequently caused by coagulase-negative Staphylococci (CoNS), which is known to be a hard-to-treat microorganism. Antibiotic resistance among causative pathogens of PJI is increasing. Two-stage revision is the favoured treatment for chronic CoNS infection of a hip or knee prosthesis. We hypothesised that the infection eradication rate of our treatment protocol for two-stage revision surgery for CoNS PJI of the hip and knee would be comparable to eradication rates described in the literature.
To evaluate the infection eradication rate of two-stage revision arthroplasty for PJI caused by CoNS.
All patients treated with two-stage revision of a hip or knee prosthesis were retrospectively included. Patients with CoNS infection were included in the study, including polymicrobial cases. Primary outcome was infection eradication at final follow-up.
Forty-four patients were included in the study. Twenty-nine patients were treated for PJI of the hip and fifteen for PJI of the knee. At final follow-up after a mean of 37 mo, recurrent or persistent infection was present in eleven patients.
PJI with CoNS can be a difficult to treat infection due to increasing antibiotic resistance. Infection eradication rate of 70%-80% may be achieved.
Core tip: Periprosthetic joint infections of the hip and knee caused by coagulase-negative Staphylococci can be difficult to treat. We retrospectively reviewed all patients treated with two-stage revision arthroplasty for such an infection in our hospital between 2003 and 2016. We treated 44 patients with coagulase-negative Staphylococci infection of the hip or knee with a two-stage revision using an antibiotic-loaded spacer. At final follow-up, infection was eradicated in 33 of these patients.