HIGHER ONE-YEAR RISK OF IMPLANT REMOVAL FOR CULTURE-POSITIVE THAN FOR CULTURE-NEGATIVE DAIRS FOLLOWING 359 PRIMARY HIP OR KNEE ARTHROPLASTIES

J. Goosen; W. V. D. Weegen; W. Rijnen; J. V. Eck; W. Liu

doi:10.1302/1358-992X.2022.10.042

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General Orthopaedics

HIGHER ONE-YEAR RISK OF IMPLANT REMOVAL FOR CULTURE-POSITIVE THAN FOR CULTURE-NEGATIVE DAIRS FOLLOWING 359 PRIMARY HIP OR KNEE ARTHROPLASTIES

The European Bone and Joint Infection Society (EBJIS) Meeting, Graz, Austria, 8–10 September 2022.

J. Goosen
W. V. D. Weegen
W. Rijnen
J. V. Eck
W. Liu

HIGHER ONE-YEAR RISK OF IMPLANT REMOVAL FOR CULTURE-POSITIVE THAN FOR CULTURE-NEGATIVE DAIRS FOLLOWING 359 PRIMARY HIP OR KNEE ARTHROPLASTIES

Goosen J, Weegen WVD, Rijnen W, Eck JV, Liu W. HIGHER ONE-YEAR RISK OF IMPLANT REMOVAL FOR CULTURE-POSITIVE THAN FOR CULTURE-NEGATIVE DAIRS FOLLOWING 359 PRIMARY HIP OR KNEE ARTHROPLASTIES. Orthop Procs. 2022;104-B(SUPP_10):42-42. doi:10.1302/1358-992X.2022.10.042

Goosen, J., et al. “HIGHER ONE-YEAR RISK OF IMPLANT REMOVAL FOR CULTURE-POSITIVE THAN FOR CULTURE-NEGATIVE DAIRS FOLLOWING 359 PRIMARY HIP OR KNEE ARTHROPLASTIES.” Orthopaedic Proceedings, vol. 104-B, no. SUPP_10, 2022, pp. 42-42., https://doi.org/10.1302/1358-992X.2022.10.042

Goosen, J., Weegen, W. V. D., Rijnen, W., Eck, J. V., & Liu, W. (2022). HIGHER ONE-YEAR RISK OF IMPLANT REMOVAL FOR CULTURE-POSITIVE THAN FOR CULTURE-NEGATIVE DAIRS FOLLOWING 359 PRIMARY HIP OR KNEE ARTHROPLASTIES. Orthopaedic Proceedings, 104-B(SUPP_10), 42-42. https://doi.org/10.1302/1358-992X.2022.10.042

Goosen, J., Weegen, W. V. D., Rijnen, W., Eck, J. V. and Liu, W. (2022) “HIGHER ONE-YEAR RISK OF IMPLANT REMOVAL FOR CULTURE-POSITIVE THAN FOR CULTURE-NEGATIVE DAIRS FOLLOWING 359 PRIMARY HIP OR KNEE ARTHROPLASTIES.” Orthopaedic Proceedings, 104-B(SUPP_10), pp. 42-42. Available at: https://doi.org/10.1302/1358-992X.2022.10.042

Goosen, J., W. V. D. Weegen, W. Rijnen, J. V. Eck, and W. Liu. “HIGHER ONE-YEAR RISK OF IMPLANT REMOVAL FOR CULTURE-POSITIVE THAN FOR CULTURE-NEGATIVE DAIRS FOLLOWING 359 PRIMARY HIP OR KNEE ARTHROPLASTIES.” Orthopaedic Proceedings 104-B, no. SUPP_10 (2022): 42-42. https://doi.org/10.1302/1358-992X.2022.10.042

Goosen J, Weegen WVD, Rijnen W, Eck JV, Liu W. HIGHER ONE-YEAR RISK OF IMPLANT REMOVAL FOR CULTURE-POSITIVE THAN FOR CULTURE-NEGATIVE DAIRS FOLLOWING 359 PRIMARY HIP OR KNEE ARTHROPLASTIES. Orthop Procs. 2022 Oct 1;104-B(SUPP_10):42-42. https://doi.org/10.1302/1358-992X.2022.10.042

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Abstract

Aim

To date, the value of culture results after a debridement, antibiotics and implant retention (DAIR) for early (suspected) prosthetic joint infection (PJI) as risk indicators in terms of prosthesis retention is not clear. At one year follow-up, the relative risk of prosthesis removal was determined for culture-positive and culture-negative DAIRs after primary total hip or knee arthroplasty. The secondary aim was to explore differences in patient characteristics, infection characteristics and outcomes between these two groups.

Methods

A retrospective regional registry study was performed in a group of 359 patients (positive cultures: n = 299, negative cultures n = 60) undergoing DAIR for high suspicion of early PJI in the period from 2014 to 2019. Differences in patient characteristics, deceased patients and number of subsequent DAIRs between the positive and negative DAIR groups were analyzed using independent t-tests, Mann-Whitney, Pearson's Chi-square tests and Fisher's Exact tests.

Results

Overall implant survival rate following DAIR was 89%. The relative risk for prosthesis removal was 7.4 times higher (95% confidence interval (CI) 1.0–53.1) in the positive DAIR group (37/299, 12.4%) compared to the negative DAIR group (1/60, 1.7%). The positive group had a higher body mass index (p = 0.034), rate of wound leakage of >10 days (p = 0.016) and more subsequent DAIRs (p = 0.006).

Conclusion

Since implant survival results after DAIR are favorable, the threshold to perform a DAIR procedure in early PJI should be low in order to retain the prosthesis. A DAIR procedure in case of negative cultures does not seem to have unfavorable results in terms of prosthesis retention.

E-Mail: j.goosen@maartenskliniek.nl