{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T16:40:10Z","timestamp":1786984810604,"version":"build-2736575974"},"reference-count":43,"publisher":"Elsevier BV","issue":"2","license":[{"start":{"date-parts":[[2018,2,1]],"date-time":"2018-02-01T00:00:00Z","timestamp":1517443200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["clinicalkey.jp","clinicalkey.com","clinicalkey.es","clinicalkey.com.au","clinicalkey.fr","arthroplastyjournal.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Arthroplasty"],"published-print":{"date-parts":[[2018,2]]},"DOI":"10.1016\/j.arth.2017.08.037","type":"journal-article","created":{"date-parts":[[2017,9,4]],"date-time":"2017-09-04T23:30:52Z","timestamp":1504567852000},"page":"515-520","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":45,"title":["Risk Factors for Repeat Debridement, Spacer Retention, Amputation, Arthrodesis, and Mortality After Removal of an Infected Total Knee Arthroplasty With Spacer Placement"],"prefix":"10.1016","volume":"33","author":[{"given":"Jourdan M.","family":"Cancienne","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor A.","family":"Granadillo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kishan J.","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian C.","family":"Werner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A.","family":"Browne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.arth.2017.08.037_bib1","doi-asserted-by":"crossref","first-page":"624","DOI":"10.2106\/JBJS.M.00285","article-title":"Impact of the economic downturn on total joint replacement demand in the United States: updated projections to 2021","volume":"96","author":"Kurtz","year":"2014","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2017.08.037_bib2","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1007\/s00264-013-2265-y","article-title":"Periprosthetic joint infection\u2013effect on quality of life","volume":"38","author":"Helwig","year":"2014","journal-title":"Int Orthop"},{"key":"10.1016\/j.arth.2017.08.037_bib3","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1007\/s11999-012-2595-x","article-title":"Two-stage treatment of hip periprosthetic joint infection is associated with a high rate of infection control but high mortality","volume":"471","author":"Berend","year":"2013","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2017.08.037_bib4","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.arth.2012.02.022","article-title":"Economic burden of periprosthetic joint infection in the United States","volume":"27","author":"Kurtz","year":"2012","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2017.08.037_bib5","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1016\/j.arth.2007.10.017","article-title":"Infection burden for hip and knee arthroplasty in the United States","volume":"23","author":"Kurtz","year":"2008","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2017.08.037_bib6","doi-asserted-by":"crossref","first-page":"780","DOI":"10.2106\/00004623-200704000-00012","article-title":"Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030","volume":"89","author":"Kurtz","year":"2007","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2017.08.037_bib7","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/s11999-009-0945-0","article-title":"The epidemiology of revision total knee arthroplasty in the United States","volume":"468","author":"Bozic","year":"2010","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2017.08.037_bib8","doi-asserted-by":"crossref","first-page":"3049","DOI":"10.1007\/s11999-011-2030-8","article-title":"Two-stage exchange arthroplasty for infected total knee arthroplasty: predictors of failure","volume":"469","author":"Mortazavi","year":"2011","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2017.08.037_bib9","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1093\/jac\/dkp469","article-title":"Two-stage revision for prosthetic joint infection: predictors of outcome and the role of reimplantation microbiology","volume":"65","author":"Bejon","year":"2010","journal-title":"J\u00a0Antimicrob Chemother"},{"key":"10.1016\/j.arth.2017.08.037_bib10","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1007\/s11999-010-1579-y","article-title":"Durable infection control and function with the PROSTALAC spacer in two-stage revision for infected knee arthroplasty","volume":"469","author":"Gooding","year":"2011","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2017.08.037_bib11","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1016\/j.arth.2009.07.017","article-title":"Modern treatment of infected total knee arthroplasty with a 2-stage reimplantation protocol","volume":"25","author":"Westrich","year":"2010","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2017.08.037_bib12","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1007\/s11999-010-1425-2","article-title":"Treatment based on the type of infected TKA improves infection control","volume":"469","author":"Kim","year":"2011","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2017.08.037_bib13","doi-asserted-by":"crossref","first-page":"2730","DOI":"10.1007\/s11999-012-2358-8","article-title":"Assessing the gold standard: a review of 253 two-stage revisions for infected TKA","volume":"470","author":"Mahmud","year":"2012","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2017.08.037_bib14","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1097\/00003086-200211000-00021","article-title":"Results of periprosthetic hip and knee infections caused by resistant bacteria","author":"Kilgus","year":"2002","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2017.08.037_bib15","doi-asserted-by":"crossref","first-page":"e154-1","DOI":"10.2106\/JBJS.M.01289","article-title":"Morbid obesity: a significant risk factor for failure of two-stage revision total knee arthroplasty for infection","volume":"96","author":"Watts","year":"2014","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2017.08.037_bib16","doi-asserted-by":"crossref","first-page":"e104-1","DOI":"10.2106\/JBJS.K.01417","article-title":"Management of periprosthetic joint infection: the current knowledge","volume":"94","author":"Parvizi","year":"2012","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2017.08.037_bib17","doi-asserted-by":"crossref","first-page":"1699","DOI":"10.1007\/s11999-009-0742-9","article-title":"Staged revision for knee arthroplasty infection: what is the role of serologic tests before reimplantation?","volume":"467","author":"Ghanem","year":"2009","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2017.08.037_bib18","doi-asserted-by":"crossref","first-page":"11","DOI":"10.5604\/15093492.1097485","article-title":"Success rates for initial eradication of peri-prosthetic knee infection treated with a two-stage procedure","volume":"16","author":"Kaminski","year":"2014","journal-title":"Ortop Traumatol Rehabil"},{"key":"10.1016\/j.arth.2017.08.037_bib19","doi-asserted-by":"crossref","first-page":"180","DOI":"10.4055\/cios.2013.5.3.180","article-title":"Revision of infected total knee arthroplasty: two-stage reimplantation using an antibiotic-impregnated static spacer","volume":"5","author":"Silvestre","year":"2013","journal-title":"Clin Orthop Surg"},{"key":"10.1016\/j.arth.2017.08.037_bib20","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1007\/s00264-013-2241-6","article-title":"Two-stage treatment of infected total knee arthroplasty: two to thirteen year experience using an articulating preformed spacer","volume":"38","author":"Castelli","year":"2014","journal-title":"Int Orthop"},{"key":"10.1016\/j.arth.2017.08.037_bib21","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1016\/j.arth.2008.07.004","article-title":"Treatment of infected total hip arthroplasty with a 2-stage reimplantation protocol","volume":"24","author":"Toulson","year":"2009","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2017.08.037_bib22","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.2106\/JBJS.N.00958","article-title":"The fate of spacers in the treatment of periprosthetic joint infection","volume":"97","author":"Gomez","year":"2015","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2017.08.037_bib23","doi-asserted-by":"crossref","first-page":"e64-1","DOI":"10.2106\/JBJS.O.00724","article-title":"Rethinking the definition of success in the management of a periprosthetic joint infection","volume":"97","author":"Blumenfeld","year":"2015","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2017.08.037_bib24","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1007\/s11420-016-9507-7","article-title":"Poor prognosis of patients treated for periprosthetic joint infection","volume":"13","author":"Kahlenberg","year":"2017","journal-title":"HSS J"},{"key":"10.1016\/j.arth.2017.08.037_bib25","doi-asserted-by":"crossref","first-page":"2834","DOI":"10.1016\/j.arth.2017.03.061","article-title":"Removal of an infected hip arthroplasty is high-risk surgery: putting morbidity into context with other major non-orthopaedic operations","volume":"32","author":"Browne","year":"2017","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2017.08.037_bib26","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1016\/j.arth.2016.08.002","article-title":"Periprosthetic infection recurrence after 2-stage exchange arthroplasty: failure or fate?","volume":"32","author":"Triantafyllopoulos","year":"2017","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2017.08.037_bib27","doi-asserted-by":"crossref","first-page":"2177","DOI":"10.2106\/JBJS.L.00789","article-title":"Periprosthetic joint infection increases the risk of one-year mortality","volume":"95","author":"Zmistowski","year":"2013","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2017.08.037_bib28","doi-asserted-by":"crossref","first-page":"631","DOI":"10.2106\/JBJS.I.01256","article-title":"Comparison of one and two-stage revision of total hip arthroplasty complicated by infection","volume":"93","author":"Wolf","year":"2011","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2017.08.037_bib29","first-page":"807","article-title":"The PROSTALAC functional spacer in two-stage revision for infected knee replacements","volume":"8282","author":"Beauchamp","year":"2000","journal-title":"J\u00a0Bone Joint Surg Br"},{"key":"10.1016\/j.arth.2017.08.037_bib30","doi-asserted-by":"crossref","first-page":"93","DOI":"10.5792\/ksrr.2013.25.3.93","article-title":"Infection following total knee arthroplasty","volume":"25","author":"Chun","year":"2013","journal-title":"Knee Surg Relat Res"},{"key":"10.1016\/j.arth.2017.08.037_bib31","doi-asserted-by":"crossref","DOI":"10.1007\/s00590-017-1952-6","article-title":"Risk factors for amputation in periprosthetic knee infection","author":"Polanco-Armenta","year":"2017","journal-title":"Eur J Orthop Surg Traumatol"},{"key":"10.1016\/j.arth.2017.08.037_bib32","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/s12877-016-0215-4","article-title":"The effects of advanced age on primary total knee arthroplasty: a meta-analysis and systematic review","volume":"16","author":"Kuperman","year":"2016","journal-title":"BMC Geriatr"},{"key":"10.1016\/j.arth.2017.08.037_bib33","doi-asserted-by":"crossref","DOI":"10.1016\/j.arth.2017.06.038","article-title":"Effect of type 2 diabetes on in-hospital postoperative complications and mortality after primary total hip and knee arthroplasty","author":"Mart\u00ednez-Huedo","year":"2017","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2017.08.037_bib34","doi-asserted-by":"crossref","first-page":"1642","DOI":"10.1007\/s11999-017-5246-4","article-title":"Is there an association between hemoglobin A1C and deep postoperative infection after TKA?","volume":"475","author":"Cancienne","year":"2017","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2017.08.037_bib35","first-page":"23","article-title":"Asymptomatic peripheral vascular disease in total knee arthroplasty: preoperative prevalence and risk factors","volume":"16","author":"Park","year":"2015","journal-title":"J\u00a0Orthop Traumatol"},{"key":"10.1016\/j.arth.2017.08.037_bib36","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.arth.2015.09.003","article-title":"Complications and mortality in chronic renal failure patients undergoing total joint arthroplasty: a comparison between dialysis and renal transplant patients","volume":"31","author":"Cavanaugh","year":"2016","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2017.08.037_bib37","doi-asserted-by":"crossref","first-page":"e4835","DOI":"10.1097\/MD.0000000000004835","article-title":"Complications after total knee replacement in patients with chronic obstructive pulmonary disease","volume":"95","author":"Liao","year":"2016","journal-title":"Medicine (Baltimore)"},{"key":"10.1016\/j.arth.2017.08.037_bib38","doi-asserted-by":"crossref","DOI":"10.1007\/s12178-017-9421-8","article-title":"Factors that affect outcome following total joint arthroplasty: a review of the recent literature","author":"Schwartz","year":"2017","journal-title":"Curr Rev Musculoskelet Med"},{"key":"10.1016\/j.arth.2017.08.037_bib39","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1016\/j.arth.2013.07.013","article-title":"The fate of unplanned retention of prosthetic articulating spacers for infected total hip and total knee arthroplasty","volume":"29","author":"Choi","year":"2014","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2017.08.037_bib40","doi-asserted-by":"crossref","first-page":"629","DOI":"10.2106\/JBJS.16.00287","article-title":"Ambulatory total shoulder arthroplasty","volume":"99","author":"Cancienne","year":"2017","journal-title":"J\u00a0Bone Joint Surg"},{"key":"10.1016\/j.arth.2017.08.037_bib41","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1177\/0363546515610505","article-title":"Tobacco use is associated with increased complications after anterior cruciate ligament reconstruction","volume":"44","author":"Cancienne","year":"2016","journal-title":"Am J Sports Med"},{"key":"10.1016\/j.arth.2017.08.037_bib42","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.knee.2012.06.004","article-title":"Two-stage reimplantation for periprosthetic knee infection: influence of host health status and infecting microorganism","volume":"20","author":"Tigani","year":"2013","journal-title":"Knee"},{"key":"10.1016\/j.arth.2017.08.037_bib43","doi-asserted-by":"crossref","first-page":"19","DOI":"10.2106\/JBJS.16.00075","article-title":"Repeat two-stage exchange arthroplasty for periprosthetic knee infection is dependent on host grade","volume":"99","author":"Fehring","year":"2017","journal-title":"J\u00a0Bone Joint Surg"}],"container-title":["The Journal of Arthroplasty"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S088354031730760X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S088354031730760X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2020,10,16]],"date-time":"2020-10-16T23:07:21Z","timestamp":1602889641000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S088354031730760X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2]]},"references-count":43,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018,2]]}},"alternative-id":["S088354031730760X"],"URL":"https:\/\/doi.org\/10.1016\/j.arth.2017.08.037","relation":{},"ISSN":["0883-5403"],"issn-type":[{"value":"0883-5403","type":"print"}],"subject":[],"published":{"date-parts":[[2018,2]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Risk Factors for Repeat Debridement, Spacer Retention, Amputation, Arthrodesis, and Mortality After Removal of an Infected Total Knee Arthroplasty With Spacer Placement","name":"articletitle","label":"Article Title"},{"value":"The Journal of Arthroplasty","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.arth.2017.08.037","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2017 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}