Abstract
Aim
To describe the impact of a failed DAIR in the further prognosis of the prosthesis after a PJI
Method
A retrospective multicentrically study was conducted, including 10 institutions from all over the country. PJI-confirmed patients who underwent DAIR clinical records were revised. Age, sex, relevant previous conditions, Charlson comorbidity score, previous surgery, PJI diagnosis and surgical and antibiotic treatment, from the index surgery onwards. DAIR failure was defined as the removal of the prosthesis and/or an antibiotic suppressive treatment.
Results
95 failed DAIR were identified, 43 of whom were treated with another DAIR (70% success rate), 20 with one-stage revision (75% success rate) and 25 with two-stage revision (92% success rate).
As risk factors for the failure of a second DAIR, a non-specialized surgical team(p=.0034), mobile components exchange(p=.009) and polymicrobial infections(p=.03) were identified.
Regarding to one-stage revisions, no risk factors were identified, and regarding to two-stage revisions, polymicrobial infection were identified (p=.028)
Conclusions
A second DAIR could sabe up to 70% of the prosthesis in our series. Furthermore, the outcome of the subsequent one or two-stage revision does not seem to be affected bay the previous failed DAIR. In terms of risk factors of failure, non-specialized surgical team, no mobile components exchange, and polymicrobial infections were identified for the DAIR, and polymicrobial infections for the two-stage revisions.
