Checklist of criteria for successful salvage of infected joint prosthesis

• No instability or loosening of the prosthesis (clinically or on X-ray)
   
• Good quality of soft tissues with no sinus formation
   
• Not immunosuppressed
   
• Not presenting with septic shock
   
• Short duration of symptoms before presentation
   
  • < 3 days if acute hematogenous presentation in longstanding joint
     
  • < 2 weeks if occurring in the setting of a recently implanted joint
     
• Patient fully informed and accepting of the harms and benefits of this approach
   
  • Versus higher likelihood of treatment success with 2 stage procedure
     
• If organism = MRSA or MRSE, then it's sensitive to both rifampicin and fusidic acid
   
• Open debridement with synovectomy and polyethylene exchange better than arthroscopic washout and debridement
   
• Some organisms do better than others (Streptococcus > S. aureus or Gram negative > MRSA > 2 organisms > fungal [which needs 2 stage])
   

(Adapted from the Australian Therapeutic Guidelines: Antibiotic)