Outcomes following a single-stage procedure are affected by many factors based on the immunological status of the patient, the local soft-tissue and bony characteristics, and the microbiological profile.
Promising infection-free outcomes have been reported when strict criteria for the selection of patients are applied
Early experience of single-staged exchange arthroplasty by Buchholz et al in 1981, reported an overall success rate of 77% in a series of 583 patients.They noted that the microbiological profile was important in determining outcome, with polymicrobial infections and atypical and gram-negative organisms being associated with a higher failure rate.
Jackson et al, in 2000, in a review of the literature concluded that in addition to these factors, infection with MRSA or MRSE resistant organisms was associated with a poor outcome.
As it involves fewer surgical procedures
It is more cost-effective, with a shorter period of hospitalization and reduced use of antibiotics.
Aggressive debridement of bone and soft tissue with removal of components and cement may be required, that can result in significant bone loss requiring expert reconstructive surgery.