Systematic review and meta-analysis of single-stage vs two-stage revision for periprosthetic joint infection: a call for a prospective randomized trial
Abstract Background Periprosthetic joint infection (PJI) is a severe complication of joint arthroplasty that causes significant pain and economic loss. This study aimed to determine whether the current evidence supports single-stage revision for PJI based on reinfection and reoperation rates. Method...
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-024-07229-z |
| _version_ | 1827328905508290560 |
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| author | Yong Zhao Shaohua Fan Zhangfu Wang Xueli Yan Hua Luo |
| author_facet | Yong Zhao Shaohua Fan Zhangfu Wang Xueli Yan Hua Luo |
| author_sort | Yong Zhao |
| collection | DOAJ |
| description | Abstract Background Periprosthetic joint infection (PJI) is a severe complication of joint arthroplasty that causes significant pain and economic loss. This study aimed to determine whether the current evidence supports single-stage revision for PJI based on reinfection and reoperation rates. Methods We searched the PubMed, EBSCO, Medline, and Cochrane Library databases from inception to 30 May 2023 to identify studies that compared single-stage revision and two-stage revision for PJI. Data on reinfection and reoperation rates were pooled. Results This meta-analysis included a total of 40 studies with 8711 patients. Overall, there was no significant difference between single- and two-stage revision regarding the postoperative reinfection rate and reoperation rate. Subgroup analysis by surgery period and different surgical sites revealed no difference between the two groups in the reinfection and reoperation rates. Conclusions Based on the available evidence, our study did not identify a significant difference in reinfection and reoperation rates between single- and two-stage revision for PJI. Given the limitations in inclusion/exclusion criteria and the observed heterogeneity, we acknowledge the complexity of drawing strong conclusions. Therefore, we suggest that the choice between single- and two-stage revision should be carefully considered on an individual basis, taking into account patient-specific factors and further research developments. |
| first_indexed | 2024-03-07T15:25:08Z |
| format | Article |
| id | doaj.art-b9dd53a2f7794b4fb49a46c7671def38 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-03-07T15:25:08Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-b9dd53a2f7794b4fb49a46c7671def382024-03-05T17:23:56ZengBMCBMC Musculoskeletal Disorders1471-24742024-02-0125111510.1186/s12891-024-07229-zSystematic review and meta-analysis of single-stage vs two-stage revision for periprosthetic joint infection: a call for a prospective randomized trialYong Zhao0Shaohua Fan1Zhangfu Wang2Xueli Yan3Hua Luo4Department of Orthopedics, Shanghai Fengxian District Central HospitalDepartment of Orthopedics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical UniversityDepartment of Orthopedics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical UniversityDepartment of Orthopedics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical UniversityDepartment of Orthopedics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical UniversityAbstract Background Periprosthetic joint infection (PJI) is a severe complication of joint arthroplasty that causes significant pain and economic loss. This study aimed to determine whether the current evidence supports single-stage revision for PJI based on reinfection and reoperation rates. Methods We searched the PubMed, EBSCO, Medline, and Cochrane Library databases from inception to 30 May 2023 to identify studies that compared single-stage revision and two-stage revision for PJI. Data on reinfection and reoperation rates were pooled. Results This meta-analysis included a total of 40 studies with 8711 patients. Overall, there was no significant difference between single- and two-stage revision regarding the postoperative reinfection rate and reoperation rate. Subgroup analysis by surgery period and different surgical sites revealed no difference between the two groups in the reinfection and reoperation rates. Conclusions Based on the available evidence, our study did not identify a significant difference in reinfection and reoperation rates between single- and two-stage revision for PJI. Given the limitations in inclusion/exclusion criteria and the observed heterogeneity, we acknowledge the complexity of drawing strong conclusions. Therefore, we suggest that the choice between single- and two-stage revision should be carefully considered on an individual basis, taking into account patient-specific factors and further research developments.https://doi.org/10.1186/s12891-024-07229-zPeriprosthetic joint infectionSingle-stageTwo-stageReinfectionReoperation |
| spellingShingle | Yong Zhao Shaohua Fan Zhangfu Wang Xueli Yan Hua Luo Systematic review and meta-analysis of single-stage vs two-stage revision for periprosthetic joint infection: a call for a prospective randomized trial BMC Musculoskeletal Disorders Periprosthetic joint infection Single-stage Two-stage Reinfection Reoperation |
| title | Systematic review and meta-analysis of single-stage vs two-stage revision for periprosthetic joint infection: a call for a prospective randomized trial |
| title_full | Systematic review and meta-analysis of single-stage vs two-stage revision for periprosthetic joint infection: a call for a prospective randomized trial |
| title_fullStr | Systematic review and meta-analysis of single-stage vs two-stage revision for periprosthetic joint infection: a call for a prospective randomized trial |
| title_full_unstemmed | Systematic review and meta-analysis of single-stage vs two-stage revision for periprosthetic joint infection: a call for a prospective randomized trial |
| title_short | Systematic review and meta-analysis of single-stage vs two-stage revision for periprosthetic joint infection: a call for a prospective randomized trial |
| title_sort | systematic review and meta analysis of single stage vs two stage revision for periprosthetic joint infection a call for a prospective randomized trial |
| topic | Periprosthetic joint infection Single-stage Two-stage Reinfection Reoperation |
| url | https://doi.org/10.1186/s12891-024-07229-z |
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