Evidence map›Paper›PMID 35761314›Full record

ArticleJournal of orthopaedic surgery and research2022

A comparsion study between debridement, antibiotics, and implant retention and two-stage revision total knee arthroplasty for the management of periprosthetic joint infection occurring within 12 weeks from index total knee arthroplasty.

Yanchao Zhang, Zhisen Gao, Ti Zhang, Yu Dong, Zhuoqi Sheng, Fei Zhang, Yonggang Zhou, Lingfei Guo

Open access · goldAbstract read
In one paragraph

Article in Journal of orthopaedic surgery and research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
3.5field-weighted citation impact, top 7% 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

9 citing papers in PubMed, 17 citations in OpenAlex.

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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

8 authors at 3 institutions in 1 country.

Yanchao Zhang *Medical School of Chinese PLA, Beijing, 100853, China.
Zhisen Gao *Department of Orthopedics, The First Medical Center, Chinese People's Liberation Army General Hospital, Fuxing Road, Haidian District, Beijing, 100048, China.
Ti ZhangDepartment of Orthopedics, The First Medical Center, Chinese People's Liberation Army General Hospital, Fuxing Road, Haidian District, Beijing, 100048, China.
Yu DongDepartment of Orthopedics, The First Medical Center, Chinese People's Liberation Army General Hospital, Fuxing Road, Haidian District, Beijing, 100048, China.
Zhuoqi ShengMedical School of Chinese PLA, Beijing, 100853, China.
Fei ZhangMedical School of Chinese PLA, Beijing, 100853, China.
Yonggang ZhouDepartment of Orthopedics, The First Medical Center, Chinese People's Liberation Army General Hospital, Fuxing Road, Haidian District, Beijing, 100048, China. ygzhou301@163.com.
Lingfei GuoDepartment of Orthopedics, The First Medical Center, Chinese People's Liberation Army General Hospital, Fuxing Road, Haidian District, Beijing, 100048, China. guolingfei316@126.com.
Chinese People's Liberation Army · CNChinese PLA General Hospital · CNNankai University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundManaging periprosthetic joint infections are variable in practices. Debridement, antibiotics, and implant retention (DAIR) is one of the favorable interventions. Given that the success rate of the two-stage revision total knee arthroplasty (rTKA) might be overestimated. The purpose of this study is to compare the success rate between DAIR and standard two-stage rTKA with a comparable intervention time.

methodsWe retrospectively reviewed the consecutive knee periprosthetic joint infection cases which underwent DAIR or two-stage rTKA (all procedures were performed by the senior author) within 12 weeks since their primary TKA between July 2009 and October 2019. Average follow-up was 72.20 ± 40.70 months (range 29-148 months) in the DAIR group compared to 89.14 ± 43.06 months after spacer insertion (range 29-163 months) in the two-stage revision group (P = 0.156). According to different interventions, demographic data; timing of surgical intervention; hospital for special surgery knee score; and success rate were collected and compared between the DAIR group and two-stage revision group. Failure of treatment was based on the Delphi consensus and the fate of spacers. The pathogen types and failure cases were also recorded and analyzed.

resultsAverage follow-up was 72.20 ± 40.70 months (range 29-148 months) in the DAIR group compared to 89.14 ± 43.06 months after spacer insertion (range 29-163 months) in the two-stage revision group. Time from index surgery was 3.90 ± 2.92 weeks (range 0-12 weeks) in the DAIR group, and 5.11 ± 2.86 weeks (range 0-12 weeks) in the 2-stage exchange group, respectively. The success rate was 70.0% and 75.0% in the DAIR group and two-stage revision group, respectively. But no significant differences were observed between the two groups.

conclusionDAIR demonstrated comparable effectiveness with two-stage rTKA. We recommended DAIR as a choice for patients with current infection within 12 weeks after primary TKA. For methicillin-resistant staphylococcal infections and fungal infections, two-stage rTKA might be preferred.

Indexed as

Arthritis, InfectiousArthroplasty, Replacement, KneeProsthesis-Related InfectionsAnti-Bacterial AgentsDebridementHumansRetrospective StudiesTreatment OutcomeAnti-Bacterial AgentsPeriprosthetic joint infectionRevisionTotal knee arthroplasty

Identifiers

PMID35761314
PMCPMC9235174
OpenAlexW4283584676

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Registered trials

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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.