Evidence map›Paper›PMID 40682170›Full record

ArticleJournal of orthopaedic surgery and research2025

Mid-term results after DAIR for patients with acute periprosthetic joint infections of the hip or knee.

Alberto Alfieri Zellner, Niclas Watzlawik, Jonas Roos, Gunnar Thorben Rembert Hischebeth, Christian Prangenberg, Alexander Franz, Frank Sebastian Fröschen

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In one paragraph

Article in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–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

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

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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

7 authors.

Alberto Alfieri ZellnerDepartment. of Orthopedics and Trauma Surgery, University Hospital of Bonn, 53127, Bonn, Germany.
Niclas WatzlawikDepartment. of Orthopedics and Trauma Surgery, University Hospital of Bonn, 53127, Bonn, Germany.
Jonas RoosDepartment. of Orthopedics and Trauma Surgery, University Hospital of Bonn, 53127, Bonn, Germany.
Gunnar Thorben Rembert HischebethInstitute of Medical Microbiology, Immunology and Parasitology, University Clinic of Bonn, Bonn, Germany.
Christian PrangenbergDepartment. of Orthopedics and Trauma Surgery, University Hospital of Bonn, 53127, Bonn, Germany.
Alexander FranzDepartment. of Orthopedics and Trauma Surgery, University Hospital of Bonn, 53127, Bonn, Germany.
Frank Sebastian FröschenDepartment. of Orthopedics and Trauma Surgery, University Hospital of Bonn, 53127, Bonn, Germany. frank.froeschen@ukbonn.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPeriprosthetic joint infections (PJIs) are severe complications following total joint arthroplasty, with significant implications for implant longevity and patient quality of life. The debridement, antibiotics, irrigation, and implant retention (DAIR) procedure is a key strategy for managing acute PJIs while preserving the prosthesis. However, its success is highly variable, influenced by factors such as pathogen virulence and patient-specific risks. We set out to evaluate revision-free implant survival and potential risk factors influencing outcome at our institution. MATERIALS AND

methodsThis retrospective, single-center study analyzed a total of 110 patients (60 hip and 50 knee) treated for acute periprosthetic joint infections (PJI) with DAIR between 2017 and 2022. Exchange of mobile parts was undertaken in all cases. Postoperative management followed a standardized protocol, consisting of two weeks of intravenous antibiotics followed by four weeks of oral antibiotics. Clinical and radiological follow-ups were conducted at predefined intervals, assessing implant stability and signs of reinfection. Comprehensive patient data, including demographics, infection markers, microbiology, implant type, and prior surgical history, were collected and analyzed statistically.

resultsOverall, 23.6% (n = 26) of patients were lost to follow-up. Of the remaining 84 patients, we were able to detect 31 cases of tier 1 success according to Fillingham outcome criteria, which represents 36.9%. The patients in whom DAIR failed, tended to be older, have more comorbidities and showed a higher total cell count in preoperative joint aspiration. Furthermore, prior revision arthroplasty was associated with a significantly higher failure rate in the knee group.

conclusionA preoperative assessment of the likelihood of DAIR success should be undertaken for each patient. For this assessment, our data indicates to look at patient specific factors such as age, ASA score, revision implant, and preoperative cell count. These aspects may enhance risk evaluation and support the selection of an alternative treatment strategy when appropriate.

Indexed as

Arthroplasty, Replacement, HipArthroplasty, Replacement, KneeDebridementHip ProsthesisKnee ProsthesisProsthesis-Related InfectionsAcute DiseaseAgedAged, 80 and overAnti-Bacterial AgentsFemaleFollow-Up StudiesHumansMaleMiddle AgedReoperationAnti-Bacterial AgentsAcute periprosthetic infectionArthroplastyDAIRPJIRevision-free survival

Identifiers

PMID40682170
PMCPMC12275336

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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.