Evidence map›Paper›PMID 39316104›Full record

ArticleArchives of orthopaedic and trauma surgery2024

Modular component exchange has no advantage in Debridement, Antibiotics and Implant Retention (DAIR) for early onset hip and knee prosthetic joint infection.

Ashok S Gavaskar, Naveen C Tummala, Parthasarathy Srinivasan, Prakash Ayyadurai, Dheepak Ganesh, Rajashekara Reddy

Abstract read
PubMed Publisher
In one paragraph

Article in Archives of orthopaedic and trauma surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Review
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

6 authors.

Ashok S GavaskarRela Hospital, 7, CLC Works Road, Chennai, 600044, India. gavaskar.ortho@gmail.com.ORCID http://orcid.org/0000-0002-5205-4305
Naveen C TummalaSwaram Hospital, Chennai, India.
Parthasarathy SrinivasanRela Hospital, 7, CLC Works Road, Chennai, 600044, India.
Prakash AyyaduraiRela Hospital, 7, CLC Works Road, Chennai, 600044, India.
Dheepak GaneshVijaya Institute of Trauma and Orthopedics, Chennai, India.
Rajashekara ReddyVijaya Institute of Trauma and Orthopedics, Chennai, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDebridement, Antibiotics and Implant Retention (DAIR) has been the mainstay of treatment for early onset periprosthetic joint infection in spite of variable results. Modular component exchange is a widely recommended strategy to improve success rates with DAIR though very strong evidence to support its practice is still lacking. MATERIALS AND

methodsEighty six patients underwent DAIR for early onset PJI following primary hip and knee arthroplasty were divided into two groups for this retrospective review. 45 patients (group 1) underwent DAIR with modular component exchange and 41 patients without exchange (group 2). We compared success rates based on infection eradication (primary outcome variable) and need for revision surgical procedures between these two groups. We also assessed differences in primary outcome based on type of arthroplasty, timing of DAIR and addition of local antibiotics.

resultsThe overall success rate after DAIR was 71%. The outcome was similar in both groups (69% vs 74%, P = 0.66). The need for revision surgical procedures was 27% which was similar in both groups (P = 0.98) with 23% needing revision of prosthetic components. Type of arthroplasty (hip or knee) and addition of local antibiotics had no bearing on infection eradication after DAIR with or without modular component exchange. DAIR with in 45 days of primary arthroplasty had significantly higher success rate compared to DAIR after 45 days in both groups.

conclusionsWe observed that modular component exchange did not improve infection eradication after DAIR for early onset PJI following hip and knee arthroplasty. Reasonable success rates can be expected after DAIR especially if the patient develops early clinical signs and the procedure is carried out as early as possible.

Indexed as

Anti-Bacterial AgentsArthroplasty, Replacement, HipArthroplasty, Replacement, KneeDebridementHip ProsthesisKnee ProsthesisProsthesis-Related InfectionsReoperationAgedAged, 80 and overFemaleHumansMaleMiddle AgedRetrospective StudiesAnti-Bacterial AgentsComponent retentionDebridementModular component exchangePeriprosthetic infection

Identifiers

PMID39316104

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.