ArticleActa orthopaedica2023
Poor outcome after debridement and implant retention for acute hematogenous periprosthetic joint infection: a cohort study of 43 patients.
Article in Acta orthopaedica, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- A rapid-release pure iodine coating on titanium implants to mitigate acute periprosthetic infections.Frontiers in bioengineering and biotechnology · 2025Article
- Risk factors for early septic failure after two-stage exchange total knee arthroplasty for treatment of periprosthetic joint infection.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2024Article
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3 authors.
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Abstract
background and purposeThe management of acute hematogenous periprosthetic joint infection (AHI) is challenging and the optimal treatment is not clearly defined. The aim of this study was to evaluate the treatment outcome of AHI, and secondarily to investigate potential risk factors that affect outcome. PATIENTS AND
methodsWe retrospectively analyzed 43 consecutive AHIs in a total hip or knee arthroplasty between 2013 and 2020 at a single center. We used the Delphi international consensus criteria to define infection. Patients were treated by either debridement, antibiotics, and implant retention (DAIR) (n = 25), implant exchange/removal (n = 15), or suppressive antibiotics only (n = 3). AHI was defined as abrupt symptoms of infection ≥ 3 months after implantation in an otherwise well-functioning arthroplasty.
resultsAHI was most often caused by Staphylococcus aureus (16/43) and streptococcal species (13/43), but a broad spectrum of microbes were identified. 25 of 43 were treated with DAIR, with success in 10 of 25, which was significantly lower than in patients treated with removal of the implant with success in 14 of 15. S. aureus infection, knee arthroplasty, and implant age < 2 years were associated with treatment failure. The 2-year mortality rate was 8 of 43.
conclusionThe outcome following DAIR in AHIs was poor. The majority of infections were caused by virulent microbes, and we found a high mortality rate. Removal of the implant should more often be considered.
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