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The DAIR (debridement, antibiotics and implant retention) procedure for infected total knee replacement – a literature review

Prosthetic joint infection (PJI) is a devastating complication in total knee arthroplasty (TKA) and third most common cause of revision of TKA with significant morbidity and surgical challenges. Treatment options include non-operative measures with long term antibiotic suppression, debridement and i...

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Autores principales: Qasim, Sultan Naseer, Swann, Andrew, Ashford, Robert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: EDP Sciences 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5225833/
https://www.ncbi.nlm.nih.gov/pubmed/28074774
http://dx.doi.org/10.1051/sicotj/2016038
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author Qasim, Sultan Naseer
Swann, Andrew
Ashford, Robert
author_facet Qasim, Sultan Naseer
Swann, Andrew
Ashford, Robert
author_sort Qasim, Sultan Naseer
collection PubMed
description Prosthetic joint infection (PJI) is a devastating complication in total knee arthroplasty (TKA) and third most common cause of revision of TKA with significant morbidity and surgical challenges. Treatment options include non-operative measures with long term antibiotic suppression, debridement and implant retention (DAIR), one- or two-stage revision arthroplasty, arthrodesis and amputation. Implant retention without infection is ideal and DAIR has been reported to have variable success rates depending on patient factors, duration of infection, infecting micro-organisms, choice of procedure, single or multiple debridement procedures, arthroscopic or open, antibiotic choice and duration of antibiotic use. We present a thorough literature review of DAIR for infected TKA. The important factors contributing to failure are presence of sinus, immunocompromised patient, delay between onset of infection and debridement procedure, Staphylococcal infection in particular Meticillin Resistant Staphylococcal aureus, multiple debridement procedures, retention of exchangeable components and short antibiotic duration. In conclusion DAIR can be successful procedure to eradicate infection in TKA in selective patients with factors contributing to failure taken into account.
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spelling pubmed-52258332017-02-01 The DAIR (debridement, antibiotics and implant retention) procedure for infected total knee replacement – a literature review Qasim, Sultan Naseer Swann, Andrew Ashford, Robert SICOT J Review Article Prosthetic joint infection (PJI) is a devastating complication in total knee arthroplasty (TKA) and third most common cause of revision of TKA with significant morbidity and surgical challenges. Treatment options include non-operative measures with long term antibiotic suppression, debridement and implant retention (DAIR), one- or two-stage revision arthroplasty, arthrodesis and amputation. Implant retention without infection is ideal and DAIR has been reported to have variable success rates depending on patient factors, duration of infection, infecting micro-organisms, choice of procedure, single or multiple debridement procedures, arthroscopic or open, antibiotic choice and duration of antibiotic use. We present a thorough literature review of DAIR for infected TKA. The important factors contributing to failure are presence of sinus, immunocompromised patient, delay between onset of infection and debridement procedure, Staphylococcal infection in particular Meticillin Resistant Staphylococcal aureus, multiple debridement procedures, retention of exchangeable components and short antibiotic duration. In conclusion DAIR can be successful procedure to eradicate infection in TKA in selective patients with factors contributing to failure taken into account. EDP Sciences 2017-01-11 /pmc/articles/PMC5225833/ /pubmed/28074774 http://dx.doi.org/10.1051/sicotj/2016038 Text en © The Authors, published by EDP Sciences, 2017 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Qasim, Sultan Naseer
Swann, Andrew
Ashford, Robert
The DAIR (debridement, antibiotics and implant retention) procedure for infected total knee replacement – a literature review
title The DAIR (debridement, antibiotics and implant retention) procedure for infected total knee replacement – a literature review
title_full The DAIR (debridement, antibiotics and implant retention) procedure for infected total knee replacement – a literature review
title_fullStr The DAIR (debridement, antibiotics and implant retention) procedure for infected total knee replacement – a literature review
title_full_unstemmed The DAIR (debridement, antibiotics and implant retention) procedure for infected total knee replacement – a literature review
title_short The DAIR (debridement, antibiotics and implant retention) procedure for infected total knee replacement – a literature review
title_sort dair (debridement, antibiotics and implant retention) procedure for infected total knee replacement – a literature review
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5225833/
https://www.ncbi.nlm.nih.gov/pubmed/28074774
http://dx.doi.org/10.1051/sicotj/2016038
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