Can “LITE” Procedure Combined With a Short Course Antibiotic Treatment Be Effective in Treating the Chronic PJI?—A Prospective Randomized Controlled Trial
ABSTRACT Objective The prevailing treatment for chronic periprosthetic joint infection (PJI) is a two‐stage exchange, yet the optimal duration of antibiotic therapy following this procedure remains a topic of debate. This study aimed to determine whether a short course of postoperative antibiotic th...
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Wiley
2025-01-01
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| Series: | Orthopaedic Surgery |
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| Online Access: | https://doi.org/10.1111/os.14262 |
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| author | Yang Chen Haiqi Ding Qijin Wang Zida Huang Chaofan Zhang Wenbo Li Yansheng Lin Yufeng Guo Xinyu Fang Wenming Zhang |
| author_facet | Yang Chen Haiqi Ding Qijin Wang Zida Huang Chaofan Zhang Wenbo Li Yansheng Lin Yufeng Guo Xinyu Fang Wenming Zhang |
| author_sort | Yang Chen |
| collection | DOAJ |
| description | ABSTRACT Objective The prevailing treatment for chronic periprosthetic joint infection (PJI) is a two‐stage exchange, yet the optimal duration of antibiotic therapy following this procedure remains a topic of debate. This study aimed to determine whether a short course of postoperative antibiotic therapy can maintain infection control rates following a long interval two‐stage exchange (LITE) for PJI. Methods We conducted a prospective study enrolling patients with chronic PJI who underwent the LITE procedure at our institution from April 2018 to November 2021. Patients were randomly assigned to receive either a long course (12 weeks) or short course (2 weeks) of postoperative antibiotics. The pathogens, antibiotics, inflammatory markers, antibiotic‐related complications, cases of reinfection, or re‐operation were recorded. Continuous variables were analyzed using the two‐sample t‐test or Mann–Whitney U test, and categorical variables were analyzed using Fisher's exact tests. Kaplan–Meier survival analysis was used to compare infection control rates. Results A total of 60 patients with chronic PJI who completed the LITE procedure were included in the study (30 patients per group). All patients were followed for a minimum of 24 months (mean 39.2 ± 13.0 months). We observed that the infection control rate in the short‐course group was not inferior to that in the long‐course group (96.7% vs. 96.7%, p = 1.000). Conclusions For patients with chronic PJI undergoing the LITE procedure, a 2‐week course of postoperative antibiotics suffices to maintain infection control rates. Trial Registration Chinese Clinical Trial Registry: ChiCTR1900027089 |
| format | Article |
| id | doaj-art-3f51e9a38f3c40a68b76c63a0fa0ff5f |
| institution | Kabale University |
| issn | 1757-7853 1757-7861 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj-art-3f51e9a38f3c40a68b76c63a0fa0ff5f2025-01-16T05:31:15ZengWileyOrthopaedic Surgery1757-78531757-78612025-01-011719410410.1111/os.14262Can “LITE” Procedure Combined With a Short Course Antibiotic Treatment Be Effective in Treating the Chronic PJI?—A Prospective Randomized Controlled TrialYang Chen0Haiqi Ding1Qijin Wang2Zida Huang3Chaofan Zhang4Wenbo Li5Yansheng Lin6Yufeng Guo7Xinyu Fang8Wenming Zhang9Department of Orthopaedic Surgery National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University Fuzhou ChinaDepartment of Orthopaedic Surgery National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University Fuzhou ChinaDepartment of Orthopaedic Surgery National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University Fuzhou ChinaDepartment of Orthopaedic Surgery National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University Fuzhou ChinaDepartment of Orthopaedic Surgery National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University Fuzhou ChinaDepartment of Orthopaedic Surgery National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University Fuzhou ChinaDepartment of Orthopedic Surgery Changtai County Hospital Zhangzhou ChinaDepartment of Orthopedic Surgery Changtai County Hospital Zhangzhou ChinaDepartment of Orthopaedic Surgery National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University Fuzhou ChinaDepartment of Orthopaedic Surgery National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University Fuzhou ChinaABSTRACT Objective The prevailing treatment for chronic periprosthetic joint infection (PJI) is a two‐stage exchange, yet the optimal duration of antibiotic therapy following this procedure remains a topic of debate. This study aimed to determine whether a short course of postoperative antibiotic therapy can maintain infection control rates following a long interval two‐stage exchange (LITE) for PJI. Methods We conducted a prospective study enrolling patients with chronic PJI who underwent the LITE procedure at our institution from April 2018 to November 2021. Patients were randomly assigned to receive either a long course (12 weeks) or short course (2 weeks) of postoperative antibiotics. The pathogens, antibiotics, inflammatory markers, antibiotic‐related complications, cases of reinfection, or re‐operation were recorded. Continuous variables were analyzed using the two‐sample t‐test or Mann–Whitney U test, and categorical variables were analyzed using Fisher's exact tests. Kaplan–Meier survival analysis was used to compare infection control rates. Results A total of 60 patients with chronic PJI who completed the LITE procedure were included in the study (30 patients per group). All patients were followed for a minimum of 24 months (mean 39.2 ± 13.0 months). We observed that the infection control rate in the short‐course group was not inferior to that in the long‐course group (96.7% vs. 96.7%, p = 1.000). Conclusions For patients with chronic PJI undergoing the LITE procedure, a 2‐week course of postoperative antibiotics suffices to maintain infection control rates. Trial Registration Chinese Clinical Trial Registry: ChiCTR1900027089https://doi.org/10.1111/os.14262course of antibiotic treatmentlong interval two‐stage exchangeperiprosthetic joint infection |
| spellingShingle | Yang Chen Haiqi Ding Qijin Wang Zida Huang Chaofan Zhang Wenbo Li Yansheng Lin Yufeng Guo Xinyu Fang Wenming Zhang Can “LITE” Procedure Combined With a Short Course Antibiotic Treatment Be Effective in Treating the Chronic PJI?—A Prospective Randomized Controlled Trial Orthopaedic Surgery course of antibiotic treatment long interval two‐stage exchange periprosthetic joint infection |
| title | Can “LITE” Procedure Combined With a Short Course Antibiotic Treatment Be Effective in Treating the Chronic PJI?—A Prospective Randomized Controlled Trial |
| title_full | Can “LITE” Procedure Combined With a Short Course Antibiotic Treatment Be Effective in Treating the Chronic PJI?—A Prospective Randomized Controlled Trial |
| title_fullStr | Can “LITE” Procedure Combined With a Short Course Antibiotic Treatment Be Effective in Treating the Chronic PJI?—A Prospective Randomized Controlled Trial |
| title_full_unstemmed | Can “LITE” Procedure Combined With a Short Course Antibiotic Treatment Be Effective in Treating the Chronic PJI?—A Prospective Randomized Controlled Trial |
| title_short | Can “LITE” Procedure Combined With a Short Course Antibiotic Treatment Be Effective in Treating the Chronic PJI?—A Prospective Randomized Controlled Trial |
| title_sort | can lite procedure combined with a short course antibiotic treatment be effective in treating the chronic pji a prospective randomized controlled trial |
| topic | course of antibiotic treatment long interval two‐stage exchange periprosthetic joint infection |
| url | https://doi.org/10.1111/os.14262 |
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