Figure 4. Management of PJI-IV
Not a candidate for new prosthesis
Necrotizing fasciitis
OR
Sever bone loss
OR
Inability or failure of soft tissure coverage
OR
Prior failed attempt of resection arthroplasty or arthrodesis to
control infection
OR
No medical therapy available
OR
Functional benefit to amputation over resection arthroplasty
or arthrodesisa
YES
NO
Patient's comorbiditiesa
OR
Patient's preferences
preclude additional surgerya
NO
Resection arthroplasty
OR
Arthrodesisb
a
b
YES
Medical
therapy only
Consider amputation
Referral to specialty
hospital
For TKA or TEA only
Relative indication -- See full text guidelines
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