ArticleBone & joint open2021
Modular component exchange and outcome of DAIR for hip and knee periprosthetic joint infection : a systematic review and meta-regression analysis.
Article in Bone & joint open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Success rate of single versus multiple debridement, antibiotics, and implant retention (DAIR) in hip and knee periprosthetic joint infection: a systematic review and meta-analysis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Pooled it
- Treatment outcomes of periprosthetic joint infections of the elbow: a retrospective cohort study from a single referral centre.International orthopaedics · 2026Article
- The effect of post-operative continuous negative pressure therapy after debridement, antibiotics, and implant retention for acute periprosthetic joint infection.Journal of orthopaedic surgery and research · 2025Article
- Article
- Infection in Joint Arthroplasty: Diagnosis, Prevention, and Treatment Strategies-A Comprehensive Narrative Review.Life (Basel, Switzerland) · 2025Review
- [Debridement, antimicrobial therapy, and implant retention for acute periprosthetic infections].Orthopadie (Heidelberg, Germany) · 2025Review
- We need a new acronym supplementing DAIR: Introducing DECRA.Arthroplasty (London, England) · 2025Review
- Changing Incidence, Aetiology and Outcomes of Prosthetic Joint Infections: A Population-Based Study in Iceland.Journal of clinical medicine · 2025Article
- Clinical outcomes of continuous local antibiotic perfusion in combination with debridement antibiotics and implant retention for periprosthetic hip joint infection.Scientific reports · 2025Article
- Thermal insulation of poly(methyl methacrylate) bone cement and hydroxyapatite coatings under induction heating of metal implants.PloS one · 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
- The impact of rifampin on the efficacy of implant retention and prosthesis removal in staphylococcal periprosthetic joint infection.Frontiers in cellular and infection microbiology · 2025Article
- DAIR for periprosthetic joint infections-One week to save the joint?Arthroplasty (London, England) · 2024Article
- Article
- Debridement, antibiotics and implant retention (DAIR) following hip and knee arthroplasty: results and findings of a multidisciplinary approach from a non-specialist prosthetic infection centre.Annals of the Royal College of Surgeons of England · 2024Article
- Material-based treatment strategies against intraosseous implant biofilm infection.Biochemistry and biophysics reports · 2024Review
- Short-term Success in Treatment of an Acute Hematogenous Periprosthetic Hip Joint Infection with Debridement, Antibiotics, and Implant Retention.Journal of orthopaedic case reports · 2024Article
- Never mind the bug: no differences in infection-free survival after periprosthetic joint infections withFrontiers in microbiology · 2024Article
- Periprosthetic Joint Infection: Current Clinical Challenges.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Outcome of debridement, antibiotics and implant retention for streptococcal hip and knee prosthetic joint infections: A systematic review and meta-analysis.Surgery in practice and science · 2023Review
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsThe aim of this meta-analysis is to assess the association between exchange of modular parts in debridement, antibiotics, and implant retention (DAIR) procedure and outcomes for hip and knee periprosthetic joint infection (PJI).
methodsWe conducted a systematic search on PubMed, Embase, Web of Science, and Cochrane library from inception until May 2021. Random effects meta-analyses and meta-regression was used to estimate, on a study level, the success rate of DAIR related to component exchange. Risk of bias was appraised using the (AQUILA) checklist.
resultsWe included 65 studies comprising 6,630 patients. The pooled overall success after DAIR for PJI was 67% (95% confidence interval (CI) 63% to 70%). This was 70% (95% CI 65% to 75%) for DAIR for hip PJI and 63% (95% CI 58% to 69%) for knee PJI. In studies before 2004 (n = 27), our meta-regression analysis showed a 3.5% increase in success rates for each 10% increase in component exchange in DAIR for hip PJI and a 3.1% increase for each 10% increase in component exchange for knee PJI. When restricted to studies after 2004 (n = 37), this association changed: for DAIR for hip PJI a decrease in successful outcome by 0.5% for each 10% increase in component exchange and for DAIR for knee PJI this was a 0.01% increase in successful outcome for each 10% increase in component exchange.
conclusionThis systematic review and meta-regression found no benefit of modular component exchange on reduction of PJI failure. This limited effect should be weighed against the risks for the patient and cost on a case-by-case basis. The association between exchange of modular components and outcome changed before and after 2004. This suggests the effect seen after 2004 may reflect a more rigorous, evidence-based, approach to the infected implant compared to the years before.
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Registered trials
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