Observational studyClinical orthopaedics and related research2020
Lower Success Rate of Débridement and Implant Retention in Late Acute versus Early Acute Periprosthetic Joint Infection Caused by Staphylococcus spp. Results from a Matched Cohort Study.
Observational study in Clinical orthopaedics and related research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
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Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 59 citations in OpenAlex.
- Diagnostic accuracy of the monocyte-to-lymphocyte ratio in periprosthetic joint infection: a systematic review and meta-analysis.Archives of orthopaedic and trauma surgery · 2025Pooled it
- Only a partial shield: local vancomycin postpones but does not prevent hip and knee prosthetic infections.Archives of orthopaedic and trauma surgery · 2026Article
- Data from the Swiss National Arthroplasty Registry SIRIS suggest that unicompartmental knee arthroplasty is associated with a lower risk of periprosthetic joint infection than total knee arthroplasty.Archives of orthopaedic and trauma surgery · 2026Article
- Do Sonication Results of Mobile Parts Predict Failure After Debridement and Implant Retention in Acute Periprosthetic Joint Infection?Open forum infectious diseases · 2026Article
- [Debridement, antimicrobial therapy, and implant retention for acute periprosthetic infections].Orthopadie (Heidelberg, Germany) · 2025Review
- Staphylococcus aureus From Prosthetic Joint Infections and Blood Cultures Display the Same Genetic Background.APMIS : acta pathologica, microbiologica, et immunologica Scandinavica · 2025Article
- Article
- Clinical Outcome of Patients with Acute Periprosthetic Joint Infections Caused byMicroorganisms · 2025Article
- A Longer Duration of Intravenous Antibiotic Treatment for Patients with Early Periprosthetic Joint Infections Is Not Associated with a Lower Failure Rate.Antibiotics (Basel, Switzerland) · 2025Article
- Debridement, antimicrobial therapy, and implant retention (DAIR) as curative strategy for acute periprosthetic hip and knee infections: a position paper of the European Bone & Joint Infection Society (EBJIS).Journal of bone and joint infection · 2025Article
- Risk factors for treatment failure in late acute periprosthetic joint infection in patients with rheumatoid arthritis treated with surgical debridement - a case-control study.Journal of bone and joint infection · 2025Article
- Are KLIC and CRIME-80 scores useful to assist decision-making initially or at the moment of repeat DAIR? - a retrospective study.Journal of bone and joint infection · 2025Article
- Fellowship Training in Arthroplasty Improves Treatment Success of Debridement, Antibiotics, and Implant Retention for Periprosthetic Knee Infections.Arthroplasty today · 2024Article
- Early-Outcome Differences between Acute and Chronic Periprosthetic Joint Infections-A Retrospective Single-Center Study.Antibiotics (Basel, Switzerland) · 2024Article
- Current Status and Perspectives of Diagnosis and Treatment of Periprosthetic Joint Infection.Infection and drug resistance · 2024Review
- Incidence, functional outcomes and cure rate of hematogenous infection in a 2,498 Total Knee Arthroplasties cohort.Journal of experimental orthopaedics · 2023Article
- Enough is enough: salvage procedures in severe periprosthetic joint infection.Arthroplasty (London, England) · 2023Review
- Debridement, Antibiotic Pearls, and Retention of the Implant (DAPRI) in the Treatment of Early Periprosthetic Joint Infections: A Consecutive Series.Pathogens (Basel, Switzerland) · 2023Article
- Poor outcome after debridement and implant retention for acute hematogenous periprosthetic joint infection: a cohort study of 43 patients.Acta orthopaedica · 2023Article
- Outcomes of Debridement, Antibiotics and Implant Retention (DAIR) for Periprosthetic Joint Infection in a High-Volume Arthroplasty Centre.Indian journal of orthopaedics · 2022Article
Corrections and comments
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Authors and funding
16 authors at 1 institution in 10 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSurgical débridement, antibiotics and implant retention (DAIR) is currently recommended by international guidelines for both early acute (postsurgical) and late acute (hematogenous) periprosthetic joint infections (PJIs). However, due to a different pathogenesis of infection, a different treatment strategy may be needed. QUESTIONS/PURPOSES: (1) Compared with early acute PJIs, are late acute PJIs associated with a higher risk of DAIR failure? (2) When stratified by microorganism, is the higher risk of failure in late acute PJI associated with Staphylocococcus aureus infection? (3) When analyzing patients with S. aureus infection, what factors are independently associated with DAIR failure?
methodsIn this multicenter observational study, early acute and late acute PJIs treated with DAIR were retrospectively evaluated and matched according to treating center, year of diagnosis, and infection-causing microorganism. If multiple matches were available, the early acute PJI diagnosed closest to the late acute PJI was selected. A total of 132 pairs were included. Treatment success was defined as a retained implant during follow-up without the need for antibiotic suppressive therapy.
resultsLate acute PJIs had a lower treatment success (46% [60 of 132]) compared with early acute PJIs (76% [100 of 132]), OR 3.9 [95% CI 2.3 to 6.6]; p < 0.001), but the lower treatment success of late acute PJIs was only observed when caused by Staphylococcus spp (S. aureus: 34% versus 75%; p < 0.001; coagulase-negative staphylococci: 46% versus 88%; p = 0.013, respectively). On multivariable analysis, late acute PJI was the only independent factor associated with an unsuccessful DAIR when caused by S. aureus (OR 4.52 [95% CI 1.79 to 11.41]; p < 0.001).
conclusionsAlthough DAIR seems to be a successful therapeutic strategy in the management of early acute PJI, its use in late acute PJI should be reconsidered when caused by Staphylococcus spp. Our results advocate the importance of isolating the causative microorganism before surgery. LEVEL OF EVIDENCE: Level III, therapeutic study.
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