One-Stage versus Two-Stage Treatment for Prosthetic Joint Infection

This document is a randomized clinical trial report comparing one-stage and two-stage treatments for prosthetic joint infection (PJI). The study addresses the common use of a two-stage approach, highlighting the limitations of previous one-stage studies, which often lacked a comparative group and excluded patients with comorbidities or resistant organisms. The trial included 321 patients with chronic infections, following strict inclusion criteria, and aimed to assess the success rates of both treatment methods at one year. Success was defined as no reoperation for PJI. The interim analysis revealed a one-year success rate of 98% for one-stage treatment and 94% for two-stage treatment, with a relative risk of failure reduced by 61% in the one-stage group. Adverse event rates were comparable between the two groups. The findings suggest that both treatment methods yield similar success rates, contributing valuable data to the ongoing discussion regarding the optimal approach for managing PJI.