2024 AAHKS Annual Meeting: Success of Seven-Day Intra-Articular Antibiotic Irrigation for the Treatment of Chronic PJI

Ninety-three patients with periprosthetic joint infection were randomized to receive rapid exchange arthroplasty with intra-articular antibiotic irrigation (Experimental, n=46) or two-stage exchange arthroplasty (Control, n=47). The primary outcome was treatment success at 12 months, defined as receiving a permanent implant at Stage 2, survival, absence of recurrent PJI, no reoperation, and no antibiotic use. Secondary outcomes included time to reimplantation, incidence of septic failure, reoperation, and death. Outcomes were assessed over 12 months. The study found that more patients in the Experimental group received a permanent prosthesis (100% vs. 87.2%, p<0.01) and achieved significantly faster reimplantation (7 vs. 106 days, p<0.01). However, treatment success rates (58% vs. 49%, p=0.39) and rates of septic failure (p=0.72), reoperation (p=0.96), and death (p=0.25) were not statistically different. Overall, rapid exchange arthroplasty facilitated faster recovery without compromising clinical outcomes.