Expert consensus on the use of antibiotics for periprosthetic joint infection after unicompartmental knee arthroplasty

doi:10.3877/cma.j.issn.1673-9450.2025.06.004

Abstract

Abstract:

Antibiotic management for periprosthetic joint infection following unicompartmental knee arthroplasty （UKA-PJI） faces multiple challenges， which lack of standardized protocols， significant influence of surgical approach and host factors on treatment strategies， and ongoing controversies regarding management of culture-negative PJI （CN-PJI）， timing of intravenous-to-oral antibiotic conversion， local antibiotic delivery strategies， and Rifampicin use. To address these issues， leading academic organizations have collaboratively developed this consensus document based on evidence-based medicine principles， aiming to standardize and guide individualized therapeutic practices. The consensus working group synthesized available evidence-based evidence alongside clinical experience. Through multiple rounds of expert deliberation and employing the grading of recommendations assessment， development， and evaluation （GRADE） system and the reporting items for practice guidelines in healthcare （RIGHT） statement， this consensus systematically formulates an antibiotic management strategy for UKA-PJI. This document seeks to provide clinicians with an evidence-based reference for antibiotic decision-making in UKA-PJI， with the ultimate goals of enhancing infection control rates， reducing antimicrobial resistance risks， ensuring patient safety， and promoting rational antimicrobial use.

Key words: Arthroplasty，replacement，knee, Prostheses and implants, Anti- bacterial agents, Expert consensus

National Orthopedic Medical Center Knee Preservation Alliance, Chinese Aging Well Association Bone and Joint Protection and Health Branch, Expert Consensus Working Group on Antibiotic Therapy for Posteroperative Infection after Unicompartmental Knee Arthroplasty. Expert consensus on the use of antibiotics for periprosthetic joint infection after unicompartmental knee arthroplasty[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2025, 20(06): 476-489.

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References 142

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推荐强度	推荐依据
1强推荐	Ⅰ级证据，获益明确>风险
2中等推荐	Ⅱ级证据，获益可能>风险
3弱推荐	Ⅲ/Ⅳ级证据，获益与风险平衡

推荐强度	推荐依据
1强推荐	Ⅰ级证据，获益明确>风险
2中等推荐	Ⅱ级证据，获益可能>风险
3弱推荐	Ⅲ/Ⅳ级证据，获益与风险平衡

证据质量分级	定义
A（高）	非常有把握观察值接近真实值
B（中）	对观察值有中等把握：观察值有可能接近真实值，但也有可能差别很大
C（低）	对观察值的把握有限：观察值可能与真实值有很大差别
D（极低）	对观察值几乎没有把握：观察值与真实值可能有极大差别

证据质量分级	定义
A（高）	非常有把握观察值接近真实值
B（中）	对观察值有中等把握：观察值有可能接近真实值，但也有可能差别很大
C（低）	对观察值的把握有限：观察值可能与真实值有很大差别
D（极低）	对观察值几乎没有把握：观察值与真实值可能有极大差别

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[7]	& Endoscopic Surgery Group, Branch of Surgery, Chinese Medical Association Laparoscopic, Cancer Professional Committee, China Anti-Cancer Association Gastric, and Robotic Surgical Society, China Anti-Cancer Association Endoscopic, Board of the Chinese Journal of Digestive Surgery Editorial. Expert consensus on precision surgery for gastric cancer conversion therapy （2025 edition） [J]. Chinese Archives of General Surgery(Electronic Edition), 2025, 19(03): 145-156.
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[13]	Colorectal Cancer Professional Committee of the Chinese Medical Doctor Association. Expert consensus on diagnosis and treatment of colorectal cancer with ovarian metastasis (2025 Edition) [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2025, 14(04): 307-318.
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