Plain language summary Joint infections following prosthetic implants, known as periprosthetic joint infections (PJIs), are serious complications affecting patients’ health, mobility, and quality of life. These infections occur when bacteria attach to the surface of a joint implant and form a protective layer, making them hard to eliminate with antibiotics or the body’s immune system. This can lead to ongoing pain, swelling, and even joint loosening. Treating PJIs usually requires surgery. This may involve either replacing the infected implant in a single operation or a two-stage process that first removes the implant, treats the infection with antibiotics, and then replaces the implant in a second surgery. Understanding the two approaches In a single-stage surgery, doctors remove the infected implant and replace it with a new one in the same procedure. This method is often less invasive and may lead to quicker recovery. The two-stage approach, which is the usual choice for chronic infections, requires two surgeries: the first to remove the infected implant, followed by a period of antibiotics to clear the infection, and a second surgery to place a new implant. Though this takes longer, it may better control severe infections and is often used for cases with resistant bacteria or complex patient conditions. Comparative results Research on these two surgical methods shows mixed results on which surgery method works best, especially when looking at infection return rates, recovery time, and movement ability after surgery. Some studies suggest that single-stage surgery may lead to fewer complications and quicker recovery for certain patients, especially if the infection is mild and well-controlled. However, doctors still often choose the two-stage surgery for cases where the infection is more severe, resistant to treatment, or when the patient has a weaker immune system, as it may help prevent the infection from recurring in the long run. Practical implications and future directions This study highlights the importance of tailoring treatment to each patient. Factors like overall health, the type of bacteria involved, and how severe the infection is all play a big role in deciding the best approach. Single-stage surgery shows promise for simpler infections and healthier patients, but the two-stage approach is often still the preferred choice for higher-risk cases. To improve outcomes, there’s a need for more detailed, high-quality studies that can offer clear guidelines, helping doctors know when each approach is likely to work best. Societal outreach and impact of the research This study on the prognostic differences between single- and two-stage revision surgeries for periprosthetic joint infections (PJI) has considerable societal relevance, impacting both patient well-being and healthcare efficiency. PJI is a severe complication following joint replacement surgery, causing pain, prolonged recovery, and reduced mobility. The study’s findings offer insights that may streamline treatment decisions, ultimately helping patients resume daily activities more swiftly and with less disruption. By identifying more effective surgical approaches, this research supports improved quality of life for individuals facing complex joint infections, especially in an aging population where the incidence of PJI is likely to rise. Moreover, the study’s focus on comparing single-stage versus two-stage surgeries can guide healthcare systems in optimizing resource allocation. Single-stage revisions, if found to have similar or better outcomes, could reduce the need for extended hospital stays, decrease antibiotic usage, and limit the number of surgeries. This could help lessen the economic burden of PJI on healthcare systems, lowering costs for both providers and patients. In addition, the findings may influence medical guidelines and encourage the development of standardized care pathways, helping surgeons make more consistent and evidence-based decisions across diverse cases. Enhanced standardization can also lead to better infection control protocols, ultimately benefiting broader public health by reducing the recurrence of infections and hospital readmissions. Overall, this research not only seeks to improve individual outcomes but also supports a more sustainable, efficient, and patient-centered approach to managing PJIs.