Abstract
Debridement, antibiotics, and implant retention (DAIR) is a procedure to treat a periprosthetic joint infection (PJI) after total hip arthroplasty (THA) or total knee arthroplasty (TKA). The timing between the primary procedure and the DAIR is likely a determinant for its successful outcome. However, the optimal timing of a DAIR and the chance of success still remain unclear. We aimed to assess the risk of re-revision within 1 year after a DAIR procedure and to evaluate the timing of the DAIR in primary THA and TKA. We used data from the Dutch Arthroplasty Register (LROI) and selected all primary THA and TKA in the period 2007–2016 which underwent a DAIR within 12 weeks after primary procedure. A DAIR was defined as a revision for infection in which only modular parts were exchanged. A DAIR was defined as successful if not followed by a re-revision within 1 year after DAIR; 207 DAIRs were performed weeks after THA, of which 16 (8 %) received a complete revision within 1 year. DAIR procedures performed between 4 and 12 weeks () had a failure rate of 9 % (). After TKA 126 DAIRs were performed in less than weeks, of which 11 (9 %) received a complete revision within 1 year; 83 DAIRs were performed between 4 and 12 weeks, of which 14 (17 %) were revised.There was no significant difference in 1-year re-revision rate after a DAIR procedure by timing of the DAIR procedure for total hip and knee arthroplasty based on Dutch registry data.
Highlights
Periprosthetic joint infection (PJI) following hip and knee replacement surgery is a catastrophic complication with an incidence of 1 %–2 % (Zimmerli et al, 2004; Kuiper et al, 2014; Sendi et al, 2017)
Exchange of modular components as part of a DAIR procedure is recommended in total hip arthroplasty (THA) as well as total knee arthroplasty (TKA) (Qasim et al, 2017; Tsang et al, 2017; Parvizi et al, 2019)
The LROI was initiated by the Dutch Orthopaedic Association and the database has 100 % hospital coverage for hip and knee arthroplasty, with a 99 % completeness for both primary total hip and primary total knee arthroplasty (LROI, 2019)
Summary
Periprosthetic joint infection (PJI) following hip and knee replacement surgery is a catastrophic complication with an incidence of 1 %–2 % (Zimmerli et al, 2004; Kuiper et al, 2014; Sendi et al, 2017). With an increasing annual number of total joint replacements, the absolute annual incidence of PJI is increasing (Zimmerli et al, 2004; Kuiper et al, 2014). B. van der Ende et al.: DAIR for early post-surgical hip and knee PJI does not affect 1-year re-revision rates Exchange of modular components as part of a DAIR procedure is recommended in total hip arthroplasty (THA) as well as total knee arthroplasty (TKA) (Qasim et al, 2017; Tsang et al, 2017; Parvizi et al, 2019).
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
