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  • Timing of implant-removal in late acute periprosthetic joint infection : a multicenter observational study
    Wouthuyzen-Bakker, Marjan ...
    Objectives We evaluated the treatment outcome in late acute (LA) periprosthetic joint infections (PJI) treated with debridement and implant retention (DAIR) versus implant removal. Methods In a large ... multicenter study, LA PJIs of the hip and knee were retrospectively evaluated. Failure was defined as: PJI related death, prosthesis removal or the need for suppressive antibiotic therapy. LA PJI was defined as acute symptoms <3 weeks in patients more than 3 months after the index surgery and with a history of normal joint function. Results 445 patients were included, comprising 340 cases treated with DAIR and 105 cases treated with implant removal (19% one-stage revision (n%=%20), 74.3% two-stage revision (n%=%78) and 6.7% definitive implant removal (n%=%7). Overall failure in patients treated with DAIR was 45.0% (153/340) compared to 24.8% (26/105) for implant removal (p < 0.001). Difference in failure rate remained after 1:1 propensity-score matching. A preoperative CRIME80-score %3 (OR 2.9), PJI caused by S. aureus (OR 1.8) and implant retention (OR 3.1) were independent predictors for failure in the multivariate analysis. Conclusion DAIR is a viable surgical treatment for most patients with LA PJI, but implant removal should be considered in a subset of patients, especially in those with a CRIME80-score %3.
    Vir: The Journal of infection. - ISSN 0163-4453 (Vol. 79, iss. 3, Sep. 2019, str. 199-205)
    Vrsta gradiva - članek, sestavni del ; neleposlovje za odrasle
    Leto - 2019
    Jezik - angleški
    COBISS.SI-ID - 1541537476

    Povezava(-e):

    https://www.sciencedirect.com/science/article/pii/S0163445319301987?via%3Dihub#!
    DOI

vir: The Journal of infection. - ISSN 0163-4453 (Vol. 79, iss. 3, Sep. 2019, str. 199-205)
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