Debridement, antibiotics, and implant retention (DAIR) for the early prosthetic joint infection of total knee and hip arthroplasties: a systematic review - Université Claude Bernard Lyon 1 Accéder directement au contenu
Article Dans Une Revue Journal of ISAKOS Année : 2024

Debridement, antibiotics, and implant retention (DAIR) for the early prosthetic joint infection of total knee and hip arthroplasties: a systematic review

Umile Giuseppe Longo
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Sergio de Salvatore
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Benedetta Bandini
Alberto Lalli
Bruno Barillà
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Nicolaas Cyrillus Budhiparama

Résumé

Early periprosthetic joint infection (PJI) represents one of the most fearsome complications of joint replacement. No international consensus has been reached regarding the best approach for early prosthetic knee and hip infections. The aim of this updated systematic review is to assess whether debridement, antibiotics, and implant retention (DAIR) is an effective choice of treatment in early postoperative and acute hematogenous PJI. Methods: This systematic review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The diagnostic criteria defining a PJI, the most present pathogen, and the days between the index procedure and the onset of the PJI were extracted from the selected articles. Additionally, the mean follow-up, antibiotic regimen, and success rate of the treatment were also reported. Results: The articles included provided a cohort of 970 patients. Ten studies specified the joint of their cohort in PJIs regarding either hip prostheses or knee prostheses, resulting in 454 total knees and 460 total hips. The age of the patients ranged from 18 to 92 years old. Success rates for the DAIR treatments in the following cohort ranged from 55.5% up to a maximum of 90% (mean value of 71%). Conclusion: Even though the DAIR procedure is quite limited, it is still considered an effective option for patients developing an early post-operative or acute hematogenous PJI. However, there is a lack of studies, in particular randomized control trials (RCTs), comparing DAIR with one-stage and two-stage revision protocols in the setting of early PJIs, reflecting the necessity to conduct further high-quality studies to face the burden of early PJI.
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Dates et versions

hal-04475331 , version 1 (23-02-2024)

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Paternité - Pas d'utilisation commerciale - Pas de modification

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Umile Giuseppe Longo, Sergio de Salvatore, Benedetta Bandini, Alberto Lalli, Bruno Barillà, et al.. Debridement, antibiotics, and implant retention (DAIR) for the early prosthetic joint infection of total knee and hip arthroplasties: a systematic review. Journal of ISAKOS, 2024, 9 (1), pp.62 - 70. ⟨10.1016/j.jisako.2023.09.003⟩. ⟨hal-04475331⟩
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