Irrigation and Debridement With Implant Retention: Does Chronicity of Symptoms Matter?
J Arthroplasty
; 36(11): 3741-3749, 2021 Nov.
Article
em En
| MEDLINE
| ID: mdl-34419314
ABSTRACT
BACKGROUND:
Periprosthetic joint infection (PJI) remains a rare, yet devastating complication of total joint arthroplasty (TJA). Chronic infection is generally considered a contraindication to debridement, antibiotics, and implant retention (DAIR); however, outcomes stratified by chronicity have not been well documented.METHODS:
A retrospective review of all DAIR cases performed at a single institution from 2008 to 2015 was performed. Chronicity of PJI was categorized as acute postoperative, chronic, or acute hematogenous. Failure after DAIR, defined as re-revision for infection recurrence with the same organism, was evaluated between the 3 chronicity groups at 90 days as well as at a minimum 2-year follow-up.RESULTS:
Overall, 248 patients undergoing DAIR for total hip arthroplasty or total knee arthroplasty PJI were included. Categorization of PJI was acute (acute postoperative) in 59 cases (24%), chronic in 54 (22%), and acute hematogenous in 135 (54%). DAIR survivorship was 47% (range 0.3-10 years). Overall, there were 118 (47.6%) treatment failures after DAIR with a minimum of 2-year follow-up. There was no difference in failure rate between total hip or total knee arthroplasty patients (P = .07). Patients infected with Staphylococcus conferred a higher risk of failure for all DAIR procedures regardless of chronicity category.CONCLUSION:
Identification of microbial species prior to undertaking DAIR may be more clinically relevant than stratification according to chronicity category when considering treatment options.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Artrite Infecciosa
/
Infecções Relacionadas à Prótese
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
Limite:
Humans
Idioma:
En
Revista:
J Arthroplasty
Assunto da revista:
ORTOPEDIA
Ano de publicação:
2021
Tipo de documento:
Article