Abstract
Introduction
We aim to evaluate the outcome of debridement and implant retention (DAIR) procedures performed for primary total hip prosthetic joint infections (PJI) and to identify factors correlating with a successful outcome.
Methods
Patients were identified from theatre records. Electronic and paper notes were reviewed.
Results
Fifty-four DAIR procedures for infected, elective, primary total hip replacements were performed between 2010 and 2017. Complete records were available for 44 procedures. There were 22 males and 22 females. Mean age was 71 (38–89) years. Mean follow-up was 21.6 (2–52) months.
Ninety-one percent of DAIRs were performed for exogenous infections.
Procedures were performed on average 23 days from the primary procedure in exogenous infections and 11 days from onset of symptoms in haematogenous infections. Nine of 40 cases for exogenous infection were performed more than 28 days from the primary procedure.
The procedure resulted in a successful outcome in 34 cases (77%).
There was no significant difference in the time to DAIR from the primary procedure comparing successful and unsuccessful cases.
A successful outcome was associated with changing the femoral head, the procedure being performed by a revision hip surgeon, not inserting gentamicin impregnated fleece, and positive identification of the infecting organism.
Discussion
Prompt treatment with DAIR of suspected primary hip PJI can result in a high rate of successful outcome. The femoral head should always be exchanged and a delay to DAIR is preferable to the procedure being performed by a surgeon who does not routinely perform revision hip surgery.
