BACKGROUND AND PURPOSE The long-term results of the 1- or 2-stage revision procedure and infection-free prosthesis survival in a tertiary referral center are unknown. In this retrospective observational study, the long-term results of infection control and infection-free prosthesis survival of the periprosthetic joint infection-related 1- and 2-stage revision procedure are evaluated. Furthermore, the merits of performing an antibiotic-free window in the 2-stage revision is evaluated. PATIENTS AND METHODS All patients who received a 1- or 2-stage revision procedure of the hip or knee between 2010 and 2017 were included. Data was collected on patient and infection characteristics. The primary treatment aim was successful infection control without the use of antibiotic therapy afterwards. Infection-free survival analysis was performed using the Kaplan-Meier method with type of periprosthetic joint infection-related revision as covariate. Within the group of 2-stage revisions, use of an antibioticfree window was selected as covariate. RESULTS 128 patients were treated for a periprosthetic joint infection-related revision procedure (81 hips and 47 knees). Successful infection control was achieved in 18 of 21 cases for the 1-stage and 89 out of 107 cases for the 2-stage revision procedure (83%) respectively after follow-up of more than 4 years. In addition, 2-stage revision procedure infection control was achieved in 52 of 60 cases with an antibiotic-free interval and 37 of 45 cases without such interval (p = 0.6). The mean infection-free survival of the 1-stage revision was 90 months (95% CI 75-105) and 98 months (CI 90-106) for the 2-stage revision procedure. INTERPRETATION There seems to be no difference in infection control and infection-free survival between the 1- and 2-stage revision procedure. Second, an antibiotic-free window in the case of a 2-stage revision did not seem to influence treatment outcome. However, one must be cautious when interpreting these results due to confounding by indication and the small study population. Therefore, no definite conclusion can be drawn.

中文翻译：

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髋关节和膝关节感染相关翻修术感染控制率的平均 4 年评估：一项观察性研究。

背景和目的 三级转诊中心的 1 期或 2 期翻修手术和无感染假体存活的长期结果尚不清楚。在这项回顾性观察研究中，对假体周围关节感染相关的 1 期和 2 期翻修手术的感染控制和无感染假体存活的长期结果进行了评估。此外，还评估了在 2 阶段翻修中执行无抗生素窗口的优点。患者和方法 包括在 2010 年至 2017 年期间接受髋关节或膝关节一期或二期翻修手术的所有患者。收集了有关患者和感染特征的数据。主要治疗目标是在不使用抗生素治疗的情况下成功控制感染。使用 Kaplan-Meier 方法以假体周围关节感染相关翻修类型作为协变量进行无感染生存分析。在 2 阶段修订组中，选择使用无抗生素窗口作为协变量。结果 128 名患者接受了假体周围关节感染相关翻修手术（81 名髋关节和 47 名膝关节）。经过 4 年多的随访，一期翻修手术 21 例中有 18 例成功控制感染，二期翻修手术 107 例中有 89 例 (83%) 成功控制感染。此外，在无抗生素间隔的 60 例病例中有 52 例实现了 2 阶段翻修手术感染控制，在没有此类间隔的 45 例病例中有 37 例实现了感染控制 (p = 0.6)。1 期翻修的平均无感染生存期为 90 个月（95% CI 75-105），2 期翻修手术的平均无感染生存期为 98 个月（CI 90-106）。解释 1 期和 2 期翻修手术在感染控制和无感染生存方面似乎没有差异。其次，在二期翻修的情况下，无抗生素窗口似乎不会影响治疗结果。然而，由于适应症和小研究人群的混杂，在解释这些结果时必须谨慎。因此，无法得出肯定的结论。在二期翻修的情况下，无抗生素窗口似乎不会影响治疗结果。然而，由于适应症和小研究人群的混杂，在解释这些结果时必须谨慎。因此，无法得出肯定的结论。在二期翻修的情况下，无抗生素窗口似乎不会影响治疗结果。然而，由于适应症和小研究人群的混杂，在解释这些结果时必须谨慎。因此，无法得出肯定的结论。