The two-stage standard: Res ipsa loquitur

Periprosthetic joint infection is a morbid and costly complication of total knee arthroplasty. Treatment options vary depending on chronicity of the infection, causative organism, and host factors. Some authors advocate single-stage exchange arthroplasty to decrease patient morbidity and healthcare utilization costs. Due to its proven efficacy for infection eradication and soft tissue healing, however, two-stage exchange arthroplasty remains the gold standard for treatment of periprosthetic joint infection after total knee arthroplasty. In this review, we present the technique of two-stage exchange arthroplasty and evidence supporting its use.