Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017:3:2.
doi: 10.1051/sicotj/2016038. Epub 2017 Jan 11.

The DAIR (debridement, antibiotics and implant retention) procedure for infected total knee replacement - a literature review

Sultan Naseer Qasim  1 , Andrew Swann  2 , Robert Ashford  3
Affiliations

The DAIR (debridement, antibiotics and implant retention) procedure for infected total knee replacement - a literature review

Sultan Naseer Qasim et al. SICOT J. 2017.

Abstract

Prosthetic joint infection (PJI) is a devastating complication in total knee arthroplasty (TKA) and third most common cause of revision of TKA with significant morbidity and surgical challenges. Treatment options include non-operative measures with long term antibiotic suppression, debridement and implant retention (DAIR), one- or two-stage revision arthroplasty, arthrodesis and amputation. Implant retention without infection is ideal and DAIR has been reported to have variable success rates depending on patient factors, duration of infection, infecting micro-organisms, choice of procedure, single or multiple debridement procedures, arthroscopic or open, antibiotic choice and duration of antibiotic use. We present a thorough literature review of DAIR for infected TKA. The important factors contributing to failure are presence of sinus, immunocompromised patient, delay between onset of infection and debridement procedure, Staphylococcal infection in particular Meticillin Resistant Staphylococcal aureus, multiple debridement procedures, retention of exchangeable components and short antibiotic duration. In conclusion DAIR can be successful procedure to eradicate infection in TKA in selective patients with factors contributing to failure taken into account.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
PRISMA flowchart.
See this image and copyright information in PMC

References

    1. National Joint Registry for England, Wales and Northern Ireland (2014) 11th Annual Report, www.njrreports.org.uk.
    1. Pavoni GL, Giannella M, Falcone M, Scorzolini L, Liberatore M, Carlesimo B, Venditti M, Serra P (2004) Conservative medical therapy of prosthetic joint infections: retrospective analysis of an 8-year experience. Clin Microbiol Infect, 10(9), 831–837. - PubMed
    1. Merollini KM, Crawford RW, Graves N (2013) Surgical treatment approaches and reimbursement costs of surgical site infections post hip arthroplasty in Australia: a retrospective analysis. BMC Health Serv Res, 11(13), 91. - PMC - PubMed
    1. Segawa H, Tsukayama DT, Kyle RF, Becker DA, Gustillo RB (1999) Infection after total knee arthoplasty. A retrospective study of the treatment of eighty-one infections. J Bone Joint Surg Am, 81(10), 1434–1445. - PubMed
    1. Marculescu CE, Berbari EF, Hanssen AD, Steckelberg JM, Harmsen SW, Mandrekar JN, Osmon DR (2006) Outcome of prosthetic joint infections treated with debridement and retention of components. Clin Infect Dis, 42(4), 471–478. - PubMed

LinkOut - more resources