Single-stage resection and reimplantation for periprosthetic joint infection (PJI) in total hip arthroplasty (THA) is of recent interest, yet outcomes may be skewed by selected populations with healthier patients and less virulent organisms. This study quantified the effectiveness of a contemporary, evidence-based and standardized two-stage treatment protocol in patients with THA PJI including chronically infected, poor hosts. Sixty-one consecutive two-stage resection and reimplantation THAs for PJI between 2011 and 2017 were retrospectively reviewed in a prospectively collected registry database. Patients were categorized with McPherson's Staging System and infection was defined by MSIS criteria. Contemporary standardized protocols were adhered to including implant resection and meticulous surgical debridement, six-week intravenous antibiotics with a high-dose antibiotic spacer, a two-week drug holiday, and laboratory assessment of infection eradication prior to reimplantation. Extended antibiotics after reimplantation were not routinely used. Successful treatment was defined as reimplantation with component retention at minimum two-year follow-up.Introduction
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