Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science


Orthopedic Surgery


Elyse Watkins


Purpose: The purpose of this article is to review the treatment for periprosthetic joint infections (PJI).

Method: A PubMed literature search was conducted with search terms of periprosthetic joint infection treatment, osteoarthritis, and total joint replacements. Ten pertinent articles were retrieved and served as the basis for this clinical review.

Results: Based on four studies,1–4 patients with PJI symptoms less than three weeks with the prosthesis well-anchored, soft tissue intact, and no fistulas, treatment includes surgical debridement and replacement of mobile parts with antibiotics. For treatment of PJI with the prosthesis not well-anchored, soft tissues not intact, or symptoms longer than three weeks, the prosthesis needs to be removed and IV antibiotics received for at least two weeks, followed by four to ten weeks of oral antibiotics. Prosthesis removal can be completed by a one-stage revision or two-stage revisions depending on if the pathogen is known and if the pathogen is difficult to treat.

Conclusion: The standard of care treatment for PJI is determined based on length of symptoms, fistula formation, and soft tissue being intact. These factors determine if the infection is treated with surgical debridement and replacement of mobile parts versus prosthesis removal.1–4

Keywords: Periprosthetic Joint Infections treatment, Osteoarthritis, Total joint replacements


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