The Philosophy of One-Stage Septic Exchange

Total joint arthroplasty (TJA) is one of the most successful medical interventions performed today. Total hip arthroplasty (THA) was named the operation of the century by the Lancet [1], and both THA and total knee arthroplasty (TKA) have patient satisfaction rates of over 85% [2]. As well, both THA and TKA have been found to be highly cost-effective based on high-quality studies [3]. Nonetheless, these major surgeries carry risks of major complications, with periprosthetic joint infection (PJIs) being among the most common causes of revision surgery [4, 5]. While the absolute rates of PJI are low (0.5–2%) [6], the overall large volume of TJAs worldwide [7] mean PJI represents an important and challenging issue. Periprosthetic joint infections represent a devastating complication, with important implications for patients and a major burden on healthcare systems [8]. As such, the diagnosis and treatment of PJIs continues to be studied and discussed in the literature.