A decision analysis of treatment strategies for acute periprosthetic joint infection: Early irrigation and debridement versus delayed treatment based on organism.

OBJECTIVE: The purpose of this study was to investigate whether immediate or delayed tailored DAIR treatment based on microbial species is the optimal treatment for acute post-operative periprosthetic joint infection (PJI). METHODS: A multicenter retrospective study was conducted to identify patients who underwent debridement, antibiotics, and implant retention (DAIR) for PJI. Decision analysis modeling was employed to determine the treatment strategy that yielded the greatest patient outcome. RESULTS: 316 patients who underwent DAIR for PJI were identified. CONCLUSION: The decision analysis model determined that the optimal treatment strategy is to perform an immediate DAIR to achieve the greatest QALY outcomes in TKA and THA patients with acute PJI.