Prosthetic joint infection: When can prosthesis salvage be considered? Clin

Management of prosthetic joint infection (PJI) remains a therapeutic challenge. We retrospectively studied 69 infected total hip or knee arthroplasties managed between 1980 and 1996 in our institution. Treatment failure, defined as relapse of PJI in the first year following the last antimicrobial treatment, occurred for 14 patients (20.3%). None of the potentially contributive parameters analyzed was signifi-cantly predictive of treatment failure. Of the subgroup of 34 patients with PJI who initially underwent debridement with retention of the prosthesis, the 13 (38.2%) who did not require further surgical treatment had symptoms for a significantly shorter duration before debridement (4.85 vs. 54.24 days; P <.0001). Because debridement with retention of the prosthesis rarely enables control of PJI, this therapeutic approach should be considered only when the duration of symptoms is very short. The infection rate following hip or knee arthroplasty has decreased considerably since the pioneering studies were re-ported and is currently estimated to be,2.5 % [1]. However, the incidence of prosthetic joint infection (PJI) is likely to remain high in developed countries, as the number of arthro-plasties performed annually continues to rise and follow-u