Single-Stage Revision for Treatment of Prosthetic Joint Infection in Total Hip Arthroplasty.

Total hip arthroplasty (THA) is a highly successful procedure for managing hip osteoarthritis, with increasing numbers performed yearly. Prosthetic joint infection (PJI) is a devastating complication which remains one of the leading causes of implant failure and is increasing in prevalence, resulting in significant morbidity, mortality, and economic burden. Traditional management of PJI has relied on two-stage revision, but recent evidence suggests that single-stage revision may be an effective alternative for select patients. This review looks at the pathogenesis, diagnosis and classification of PJI in THA, and examines the current literature on single-stage revision for PJI in THA, including its indications, surgical technique, and clinical outcomes. Indication of the procedure is determined by the patient comorbidities and biology, and micro-organism characteristics. The surgical technique involves the removal of infected implants, thorough debridement, and reimplantation of a new prosthesis within the same procedure. Single-stage revision is associated with reduced hospital stays, lower costs, and improved patient satisfaction compared to two-stage revision. While successful eradication of infection depends on factors such as host immunity, pathogen virulence, and soft tissue viability, studies have demonstrated comparable or superior infection-free survival rates for single-stage revision. Recent advances in microbiological diagnostics, biofilm disruption techniques, and multidisciplinary perioperative management have further enhanced the efficacy of single-stage revision. Despite some contraindications, including highly resistant organisms and severe soft tissue compromise, high-volume centers have expanded their indications with promising results. As the demand for THA continues to rise, optimizing PJI treatment strategies is critical. This review highlights the growing role of single-stage revision as a viable and cost effective approach for managing PJI in carefully selected patients.