Abstract
Aim
Debridement, antibiotics and implant retention (DAIR) has become the preferred treatment in early prosthetic joint infections (PJI) and acute haematogenous PJI, but the success rates have been varying. The aim of this study was to evaluate the outcome of a high quality DAIR procedure performed according to a consistently applied surgical protocol in early PJI's and acute haematogenous PJI's in hip and knee.
Methods
We performed a prospective multicentre study in 8 hospitals in Norway. A standardized DAIR protocol was used in all patients. An empirical intravenous regimen containing cloxacillin and vancomycin was given until definitive microbiological results were known. Antibiotics were given in total for 6 weeks. The primary outcome measure was infection control. Factors that could affect the outcome were also studied.
Results
Out of 99 patients included, 82 were finally analysed. 68/82 patients were successfully trreated (82,9% (CI: 74,4%-90,2%)). We found that DAIR following an infected revision arthroplasty was associated with poor outcome (59%) compares to DAIR following a primary arhroplasty (89%, p=0,007).
Conclusion
The success rate of a standardized DAIR-procedure with 6 weeks of antibiotic treatment was good in PJI following primary prosthesis. The success rates following revision surgery infections are poor, and other treatment options should be considered.
