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Review
. 2021 Jun 18;22(1):557.
doi: 10.1186/s12891-021-04451-x.

Debridement, antibiotics, and implant retention combined with direct intra-articular antibiotic infusion in patients with acute hematogenous periprosthetic joint infection of the knee

Pruk Chaiyakit  1 , Surapoj Meknavin  2 , Natthapong Hongku  2 , Ittiwat Onklin  2
Affiliations
Review

Debridement, antibiotics, and implant retention combined with direct intra-articular antibiotic infusion in patients with acute hematogenous periprosthetic joint infection of the knee

Pruk Chaiyakit et al. BMC Musculoskelet Disord. .

Abstract

Background: Debridement, antibiotics, and implant retention (DAIR) is the recommended treatment for acute hematogenous periprosthetic joint infection (PJI) after total knee arthroplasty (TKA). However, DAIR is associated with a high percentage of unsuccessful outcomes. Since 2007, direct intra-articular antibiotic infusion, which can provide a high concentration of intra-articular antibiotic, has been used in combination with DAIR to improve treatment outcomes among patients in our institution. This study aimed to assess the outcomes of DAIR combined with direct intra-articular antibiotic infusion in patients who presented with acute hematogenous PJI after TKA.

Methods: We reviewed the data of all patients diagnosed with acute hematogenous PJI after primary TKA (from 2008 to 2015) who received DAIR combined with direct intra-articular antibiotic infusion.

Results: In total, 15 knees in 12 patients were semi-urgently treated with this method. The mean follow-up time was 93.3 (minimum: 56) months, and the longest follow-up time was 11 years. Two patients (n = 3 knees) had a well-functioning, non-infected prosthesis 6 and 10 years after the procedure. Two patients (n = 2 knees) had re-infection 2 and 5 years after surgery, and they required two-stage revision. None of the patients were lost to follow-up. Finally, 13 (86.6%) of 15 infected knees were successfully treated with this method.

Conclusions: DAIR combined with direct intra-articular antibiotic infusion is an effective treatment for acute hematogenous PJI after TKA.

Keywords: Acute hematogenous; DAIR; Intraarticular antibiotic infusion; Periprosthetic joint infection; Total knee arthroplasty.

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Conflict of interest statement

We declare no conflict of interest in this study.

Figures

Fig. 1
Fig. 1
Intraarticular double-lumen catheter was placed into left knee joint
Fig. 2
Fig. 2
This figure illustrates double-lumen catheter which used in our study
See this image and copyright information in PMC

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