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Prosthetic joint infections: diagnosis, management, and complications of the two-stage replacement arthroplasty

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Abstract

Despite improved strategies to prevent prosthetic joint infection, as the total number of joint replacements increases, so does the absolute number of infections. Radiography serves as the first-line imaging modality for the assessment of a suspected prosthetic joint infection. Additionally, serial radiographs acquired after a surgery to eradicate a prosthetic joint infection are an important clinical tool. Prosthetic joint infections are often treated with a 2-stage replacement arthroplasty utilizing a prosthesis with antibiotic-loaded acrylic cement. While complications are uncommon with this procedure, imaging may demonstrate periprosthetic fractures, as well as spacer migration, joint dislocation, and spacer fracture. We describe the classification of prosthetic joint infections, the clinical and imaging diagnosis, and treatment strategies. Familiarity with the hardware utilized in the management of the prosthetic joint infection, and its potential complications is fundamental to accurate imaging interpretation.

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Authors and Affiliations

  1. Yale Radiology and Biomedical Imaging, 330 Cedar Street, New Haven, CT, 06520, USA

    Jack Porrino, Annie Wang & Austin Moats

  2. Department of Radiology, University of Washington, 4245 Roosevelt Way NE, Seattle, WA, 98105, USA

    Hyojeong Mulcahy

  3. Department of Radiology, University of Maryland Medical Center, 22 S Greene St, Baltimore, MD, 21201, USA

    Kimia Kani

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  1. Jack Porrino
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Correspondence to Jack Porrino.

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Porrino, J., Wang, A., Moats, A. et al. Prosthetic joint infections: diagnosis, management, and complications of the two-stage replacement arthroplasty. Skeletal Radiol 49, 847–859 (2020). https://doi.org/10.1007/s00256-020-03389-w

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  • DOI: https://doi.org/10.1007/s00256-020-03389-w

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