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Purpose Revisions for periprosthetic joint infection of knee and hip arthroplasty can be performed following one- or two-stage treatment protocols. Current literature is inconclusive whether one protocol is superior to the other, as prior literature reported similar reinfection rates for both treatment options. We aimed to provide a systematic review and meta-analysis of current literature on septic arthroplasty revisions. Methods Between April 2015 and December 2020, Medline, Embase, and The Cochrane Library were searched for studies reporting reinfection outcomes in patients treated with one-stage and two-stage knee or hip revision arthroplasty. Two reviewers independently extracted data and disagreements were resolved by a third investigator. We utilized a double arcsine transformation, prior to pooling using a random-effects model. Results For hip revision arthroplasty, we identified 14 one-stage studies (n = 1237) with a pooled reinfection rate of 5.7% (95% CI 3.7–8.1%), and 46 two-stage studies (n = 5009) with a reinfection rate of 8.4% (95% CI 6.9–9.9%). For knee revision arthroplasty, 6 one-stage studies (n = 527) and 48 two-stage studies (n = 4344) were identified with reinfection rates of 12.7% (7.0–19.7%) and 16.2% (13.7–19.0%), respectively. Overall, reinfection rates did not vary substantially after subgroup analysis. Limitations of our study are the limited amount of one-stage studies that introduce a potential bias. Conclusion The reinfection rates following one- and two-stage hip and knee arthroplasty revisions were similar. Knee reinfection rates have increased compared to the previous analysis. Individual patient characteristics and adequate treatment algorithms are needed for a more individual selection approach, until a randomized trial is performed.

Scapulafracturen zijn zeldzaam en onderdeel van hoogenergetisch letsel. Ze zijn zeldzaam vanwege de musculaire bedekking en de mobiliteit van de scapula. Forse spiercontracties bij een epileptisch insult of elektrische stimulatie zijn een zeldzame oorzaak van scapula fracturen. Wij presenteren een patient met een unilaterale scapulabladfractuur, die was ontstaan na een elektrische schok van 10.000 volt. Tien weken na het trauma kon de patient zijn werk als elektricien hervatten en was de schouderfunctie volledig hersteld. Scapulafracturen na indirect trauma zijn zeldzaam en zijn zelden eerder beschreven. Artsen moeten zich bewust zijn van een mogelijke scapulafractuur bij patienten met pijn in de schouder na forse spiercontracties.