Debridement and implant retention in acute hematogenous periprosthetic joint infection after knee arthroplasty: a systematic review
- PMID: 35774927
- PMCID: PMC9239348
- DOI: 10.52965/001c.33670
Debridement and implant retention in acute hematogenous periprosthetic joint infection after knee arthroplasty: a systematic review
Abstract
Debridement, antibiotic, and implant retention (DAIR) can be used as a first surgical procedure for acute infections in patients who have well-fixed components. However, its use in hematogenous or late acute infections is still debated. This systematic review of literature aims to clarify the effectiveness of DAIR procedure in the treatment of hematogenous periprosthetic knee infections. DAIR is an effective way to treat acute hematogenous PJIs of the knee and reaches its best efficacy when performed within one week from the onset of symptoms, modular components are exchanged, and a pathogen-oriented antibiotic therapy can be set. It is safe, economic, and effective technique, but has to be performed in a very narrow temporal window.
Keywords: Acute hematogenous infection; Infection; Knee Joint; PJI.
Conflict of interest statement
No author is involved in a conflict of interest. No author has received any funding.
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References
-
- 1. Triantafyllopoulos GK, Poultsides LA, Zhang W, Sculco PK, Ma Y, Sculco TP. Periprosthetic knee infections treated with irrigation and debridement: outcomes and preoperative predictive factors. J Arthroplasty. 2015;30(4):649-657. doi:10.1016/j.arth.2014.10.026 - PubMed
-
- 2. Zhang C, Yan C, Chan P, Chiu K, Ng F. Polyethylene Insert Exchange Is Crucial in Debridement for Acute Periprosthetic Infections following Total Knee Arthroplasty. J Knee Surg. 2017;30(01):36-41. doi:10.1055/s-0036-1579667 - PubMed
-
- 3. Balato G, Di Matteo V, Di Franco C, et al. Prevention and treatment of peri-prosthetic joint infection using surgical wound irrigation. J Biol Regul Homeost Agents. 2020;34(5):17-23. https://pubmed.ncbi.nlm.nih.gov/33739000/ - PubMed
-
- 4. Ascione T, Balato G, Mariconda M, Rotondo R, Baldini A, Pagliano P. Continuous Antibiotic Therapy Can Reduce Recurrence of Prosthetic Joint Infection in Patients Undergoing 2-Stage Exchange. J Arthroplasty. 2019;34(4):704-709. doi:10.1016/j.arth.2018.12.017 - PubMed
-
- 5. Ascione T, Pagliano P, Mariconda M, et al. Factors related to outcome of early and delayed prosthetic joint infections. J Infect. 2015;70(1):30-36. doi:10.1016/j.jinf.2014.07.008 - PubMed
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