Evidence map›Paper›PMID 33123664›Full record

ArticleJB & JS open access

Debridement, Antibiotics, and Implant Retention with the Direct Anterior Approach for Acute Periprosthetic Joint Infection Following Primary THA.

R L Deijkers, E P M van Elzakker, B G Pijls

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JB & JS open access. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Observational
  5. Review
  6. Observational
  7. Review
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 1 institution in 1 country.

R L DeijkersDepartments of Orthopaedic Surgery (R.L.D. and B.G.P.) and Microbiology (E.P.M.v.E.), Haga Hospital, The Hague, the Netherlands.
E P M van ElzakkerDepartments of Orthopaedic Surgery (R.L.D. and B.G.P.) and Microbiology (E.P.M.v.E.), Haga Hospital, The Hague, the Netherlands.
B G PijlsDepartments of Orthopaedic Surgery (R.L.D. and B.G.P.) and Microbiology (E.P.M.v.E.), Haga Hospital, The Hague, the Netherlands.
Haga Hospital · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPeriprosthetic joint infection (PJI) is a devastating complication following total hip replacement. The direct anterior approach for total hip replacement is becoming increasingly popular. However, little is known about the success rate of treatment with debridement, antibiotics, and implant retention (DAIR) using the direct anterior approach. The aim of this study was to analyze the effectiveness of DAIR using this approach and identify patient and surgical factors that influence the results.

methodsSeventy-four patients (75 hips) in whom DAIR had been performed were identified from the records of the weekly multidisciplinary infection meeting and the laboratory information management systems. In 4% (3 hips), modular components were exchanged. To consider competing risks (death), we used competing risk models.

resultsThe competing risk analysis showed a successful outcome after DAIR of 82% at 4 years of follow-up; this rate was 89% at 4 years follow-up when excluding patients managed with gentamicin beads. The sensitivity analysis revealed that obesity (body mass index [BMI] of ≥30 kg/m

conclusionsDAIR using the direct anterior approach without the routine exchange of modular components offers a success rate that is comparable with other approaches for eradicating acute PJI following primary hip arthroplasty. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Identifiers

PMID33123664
PMCPMC7418914
OpenAlexW3022270729

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.