DOI: https://doi.org/10.22263/2312-4156.2026.2.80
M.V. Malitsky1, E.A. Matusevich1, A.P. Glyzdou1, O.V. Novikova1, V.P. Bulavkin1,2, A.V. Harbunou1, Y.S. Ladzik2
Experience in treatment of periprosthetic infection after endoprosthetic replacement of large joints
1Vitebsk Regional Clinical Hospital, Vitebsk, Republic of Belarus
2Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
Vestnik VGMU. 2026;25(2):80-86.
Abstract.
Objectives. To evaluate the results of using various surgical and medical treatment methods in the complex treatment of periprosthetic joint infection after large joint arthroplasty.
Material and Methods. Fifty patients with periprosthetic joint infection (PJI) of the hip and knee joints were observed and treated in the Purulent Surgery Department of Vitebsk Regional Clinical Hospital.
Results. Patients were divided into two groups based on the following criteria: bone density preservation, radiopharmaceutical uptake according to scintigraphy, extent of bone and periosteal tissue damage, presence of instability, and timing of complication onset. The first group (n=9) included patients with preserved limb function, radiopharmaceutical uptake of less than 300%, localized inflammation, and no instability. The second group (n=41) included patients in the late (over 3 months) stage of the disease with impaired limb function, radiopharmaceutical uptake exceeding 300%, and extensive inflammatory bone, periosteum, and soft tissue lesions with severe instability.
Patients in the first group underwent a one-stage procedure with complete or partial replacement of the endoprosthesis components along with antibiotic therapy. For patients in the second group, the treatment program was developed individually after a comprehensive examination and included the following approaches: a two-stage surgery with endoprosthesis removal, implantation of a cemented spacer with antibiotics, and then revision endoprosthesis replacement (10 patients); endoprosthesis removal followed by lateral thigh muscle arthroplasty on a pedicle (4 patients); endoprosthesis removal without joint reconstruction (13 patients); and conservative therapy alone (14 patients).
Conclusions. To achieve maximum treatment effectiveness for patients with PJI, a comprehensive examination and an individualized approach to the need, method, and extent of surgical treatment are required.
Keywords: peri-prosthetic infection, treatment, antimicrobial resistance.
References
1. Komarov RN, Mitrofanov VN, Novikov AV, Korolev SB. Treatment of infectious complications after hip replacement. Travmatologiya i Ortopediya Rossii. 2016;22(4):25-34. (In Russ.). doi: http://dx.doi.org/ 10.21823/2311-2905-2016-22-4-25-34
2. Kurtz SM, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. The Journal of Bone and Joint Surgery American Volume. 2007 Apr;89(4):780-785. doi: http://dx.doi.org/10.2106/JBJS.F.00222
3. Tsishkarasvili AV, Melikova RE, Novozhilova EA. Analysis of six-year monitoring of the main causative agents of periprosthetic large joint infection and their tendency to resistance. Genii Ortopedii. 2022;28(2):179-188. (In Russ.). doi: http://dx.doi.org/10.18019/1028-4427-2022-28-2-179-188
4. Parvizi J, Gehrke T, Chen AF. Proceedings of the International Consensus on Periprosthetic Joint Infection. Bone and Joint Journal. 2013 Nov;95-B(11):1450-1452. doi: http://dx.doi.org/10.1302/0301-620X.95B11.33135
5. Vinkler T, Trampush A, Rents N, Perka K, Bozhkova SA. Classification and algorithm of diagnosis and treatment of periprosthetic hip joint infection. Travmatologiya i Ortopediya Rossii. 2016;22(1):33-45. (In Russ.).
6. Tande AJ, Patel R. Prosthetic joint infection. Clinical Microbiology Reviews. 2014 Apr;27(2):302-345. doi: http://dx.doi.org/10.1128/CMR.00111-13
7. Bozhkova SA, Kasimova AR, Tikhilov RM, Polyakova EM, Rukina AN, Shabanova VV, i dr. Adverse trends in the etiology of orthopedic infection: results of 6-year monitoring of structure and resistance of leading pathogens. Travmatologiya i Ortopediya Rossii. 2018;24(4):20-31. (In Russ.). doi: http://dx.doi.org/10.21823/2311-2905-2018-24-4-20-31
Submitted 23.01.2026
Accepted 14.04.2026
Information about authors:
M.V. Malitsky – traumatologist of the purulent surgery department, Vitebsk Regional Clinical Hospital;
E.A. Matusevich – Candidate of Medical Sciences, chief physician of Vitebsk Regional Clinical Hospital;
A.P. Glyzdou – surgeon, Head of the purulent surgery department, Vitebsk Regional Clinical Hospital;
O.V. Novikova – surgeon of Regional Scientific and Practical Centre “Infection in Surgery”, Vitebsk Regional Clinical Hospital, e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра.;
V.P. Bulavkin – Candidate of Medical Sciences, associate professor of the Chair of Hospital Surgery with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University;
A.V. Harbunou – surgeon of Regional Scientific and Practical Centre “Infection in Surgery”, Vitebsk Regional Clinical Hospital;
Y.S. Ladzik – lecturer of the Chair of Hospital Surgery with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University, https://orcid.org/0000-0002-5563-0275
