Abstract
Objective To present clinical effects of debridement, antibiotics, irrigation and retention of implant (DAIR) with integrated antibiotics application in treating periprosthetic joint infection (PJI) occurred within 3 months after primary surgery. Methods We retrospectively analyzed patients who received DAIR between January 2011 and October 2015. A total of 49 patients with a mean age of 62.38±14.56 years (range, 26-82 years) were included in this study, including 29 males and 20 females. There are 27 knees and 22 hips. Twenty-three patients has sinus tract. Failure was defined as subsequent surgical intervention for infection after the index procedure; persistent fistula, drainage, or excessive joint pain at the last follow-up; death related to the PJI; chronic suppression with antibiotics. Results There were 18 (36.7%) culture negative cases and 31 (63.3%) culture positive cases, including 28.6% (14/49) methicillin-sensitive staphylococcus aureus, 4% (2/49) methicillin-resistant staphylococcus aureus, 2% (1/49) methicillin-resistant staphylococcus epidermidis, 2%(1/49) mixed infection with fungus and so on. Within the 68.34±14.02 months (range, 39-94 months) follow-up duration, the Knee Society Score (KSS) score was improved from 38.37±12.39 points (range, 18-62 points) pre-operatively to 82.26±10.50 points (range, 49-96 points) post-operatively (t=-17.09, P<0.001). KSS function score was improved from 42.19±10.14 points (range, 26-67 points) pre-operatively to 75.22±11.60 points (range, 41-90 points) post-operatively (t=-12.53, P<0.001). Harris hip score was improved from 47.41±8.39 points (range, 32-58 points) pre-operatively to 86.41±6.07 points (range, 71-96 points) post-operatively (t=-23.38, P<0.001). There were 6 patients receiving subsequent surgical intervention as failure. The mean duration from the index surgery to failure was 5.75±3.00 months (range, 1.5-10 months). Conclusion The present protocol of DAIR for dealing with early-stage PJI, which is less than 3 months after primary TKA or THA, is fairly effective. Key words: Prosthesis-related infections; Debridement; Anti-infective agents, local
Published Version
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