Jesse Otero, MD, PhD: Reinventing How We Treat Joint Replacement Infection

Dr. Jesse Otero, MD, PhD joins The Joint Replacement Podcast for a deep conversation about complex joint replacement, periprosthetic joint infection, research, and building a career around the patients other surgeons often find most challenging.Jesse shares the unconventional strategy he used to build a busy practice early in his career, including calling local surgeons and offering to take the revision, infection, and complex cases they did not want to manage. His first 17 cases were infected revisions, helping establish a career focused on being the surgeon other surgeons call when a case becomes difficult.He also tells the deeply personal story of his grandfather’s knee replacement complication and subsequent infection, an experience that helped redirect his career toward solving the devastating problem of PJI.We then discuss how the OrthoCarolina PJI program developed a registry containing approximately 5,500 patients, how a busy private practice can still produce high-level clinical research, and why standardizing care can transform everyday clinical practice into a research engine. Finally, Jesse breaks down their prospective randomized multicenter trial of one-stage versus two-stage exchange for chronic periprosthetic joint infection headed by his colleague Thomas K. Fehring, MD. Among 232 randomized patients, infection-free success at two years was 97% after one-stage exchange versus 91% after two-stage exchange, with the trial demonstrating noninferiority of the one-stage strategy when performed using their rigorous protocol.A fascinating discussion about surgical complexity, research, complications, resilience, and what may be the next major evolution in treating infected hip and knee replacements.