Surgical Management of Periprosthetic Joint Infections in Hip and Knee Megaprostheses

Medicina (Kaunas). 2024 Mar 31;60(4):583. doi: 10.3390/medicina60040583.

Abstract

Periprosthetic joint infection is a feared complication after the megaprosthetic reconstruction of oncologic and non-oncologic bone defects of including the knee or hip joint. Due to the relative rarity of these procedures, however, optimal management is debatable. Considering the expanding use of megaprostheses in revision arthroplasty and the high revision burden in orthopedic oncology, the risk of PJI is likely to increase over the coming years. In this non-systematic review article, we present and discuss current management options and the associated results focusing on studies from the last 15 years and studies from dedicated centers or study groups. The indication, surgical details and results in controlling infection are presented for debridement, antibiotics, irrigation and retention (DAIR) procedure with an exchange of the modular components, single-stage implant exchange, two-stage exchanges and ablative procedures.

Keywords: hip arthroplasty; knee arthroplasty; megaprostheses; megaprosthesis; metastases; revision arthroplasty; sarcoma.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use
  • Arthroplasty, Replacement, Hip / adverse effects
  • Arthroplasty, Replacement, Hip / methods
  • Arthroplasty, Replacement, Knee / adverse effects
  • Arthroplasty, Replacement, Knee / methods
  • Debridement* / methods
  • Hip Prosthesis / adverse effects
  • Humans
  • Knee Prosthesis / adverse effects
  • Prosthesis-Related Infections* / surgery
  • Reoperation / methods
  • Therapeutic Irrigation / methods

Substances

  • Anti-Bacterial Agents

Grants and funding

This research was funded by the Open Access publication funds of the University of Münster and the medical faculty of the University of Münster who paid the publication fee.