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Getting the latest healthcare news for you
Getting the latest healthcare news for you
One surgery may be enough for joint infections. A new randomized trial found that one-stage exchange arthroplasty for chronic periprosthetic joint infection (PJI) matched — and may even outperform — the traditional two-stage approach. At 2-year follow-up, the one-stage group had a 97% success rate vs. 91% for two-stage, offering patients a faster recovery with fewer operations.
One surgery may be enough for joint infections
For decades, treating chronic periprosthetic joint infections (PJI) — infections that develop around artificial hip or knee implants — has typically meant two separate surgeries months apart. A new prospective, multicenter randomized trial is now challenging that standard, showing that a carefully executed one-stage exchange arthroplasty can deliver outcomes that are at least as good, if not better.
The trial, led by Dr. Thomas Fehring of OrthoCarolina, enrolled 258 patients with chronic PJI following primary total hip or knee arthroplasty. All sites followed strict, standardized protocols — including meticulous debridement, a double instrument setup, and a rigorous antibiotic regimen (6 weeks of IV antibiotics followed by 6 months of oral antibiotics).
By the Numbers
Why it matters: Beyond clinical outcomes, the one-stage approach is a win for patients — sparing them a second major surgery and months of waiting — and for the healthcare system, which benefits from reduced costs. Experts caution, however, that replicating these results requires reproducing the entire standardized care system, not just switching to a one-stage procedure.
