Debridement, antibiotics and implant retention (DAIR): An effective treatment option for early prosthetic joint infections

Tatarelli, Paola; Romani, T.; Santoro, Vincent M.; Spezia, M.; Gallo, Anna; Ripamonti, G.; Carducci, Michael P.; Trotti, C.; Parisini, Andrea; Nicolini, Laura Ambra; Mikulska, Małgorzata; Borrè, Silvio; Bassetti, Matteo

doi:10.1016/j.jiac.2021.03.009

Cited by 9 publications

(7 citation statements)

References 43 publications

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“…Arthroscopy in IAFF has been found to be safe and effective. The conventional paradigm is to delay the release of joint stiffness when an uncontrolled infection in a synovial joint with relatively preserved cartilage is present [ 4 , 9 ].…”

Section: Clinical Discussionmentioning

confidence: 99%

Arthroscopic debridement for infection after fracture fixation (IAFF) of the ankle: A case report

Wiratnaya

Nugraha

Kawiyana

et al. 2022

International Journal of Surgery Case Reports

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Introduction and importance Infection after fracture fixation (IAFF) is one of the most challenging issues for the lower-middle class socioeconomic. It is also related to unsatisfactory outcome of the treatment. Arthroscopy usually used to treat joint disease, but the evidence of arthroscopic management in IAFF is still limited. Case presentation We present a case of 54-year-old female with IAFF of the ankle. An arthroscopic debridement and soft tissue release procedure were performed in this patient in one stage because the irrigation and debridement were sufficient. It showed a good result good functional outcome. Clinical discussion The aims of IAFF treatment are to eradicate the infection, promote healing of soft tissue, prevent osteomyelitis, restore the joint function, and fracture consolidation. Arthroscopy in IAFF has been found to be safe and effective. In this case, arthroscopy was done in one stage because the debridement and irrigation were sufficient while the delay of the release would result in further pain and morbidity for the patient. Conclusion Arthroscopic debridement with simultaneous release of impingement and stiffness is a novel, safe, and promising option in to eliminate both IAFF and its further complications of the ankle region.

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Section: Clinical Discussionmentioning

confidence: 99%

Arthroscopic debridement for infection after fracture fixation (IAFF) of the ankle: A case report

Wiratnaya

Nugraha

Kawiyana

et al. 2022

International Journal of Surgery Case Reports

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“…As previously mentioned, the treatment success rate of DAIR is highly variable, ranging from approximately 30% to 90% efficacy [83,[116][117][118]. One factor not previously discussed that can determine the success of a DAIR procedure is early intervention [100].…”

Section: One-stage and Dairmentioning

confidence: 99%

A review of current practices in periprosthetic joint infection debridement and revision arthroplasty

et al. 2022

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Background Periprosthetic joint infection remains a significant challenge for arthroplasty surgeons globally. Over the last few decades, there has been much advancement in terms of treatment and diagnosis, however, the fight rages on. As management of periprosthetic joint infections continues to evolve, it is critical to reflect back on current debridement practices to establish common ground as well as identify areas for future research and improvement. Body In order to understand the debridement techniques of periprosthetic joint infections, one must also understand how to diagnose a periprosthetic joint infection. Multiple definitions have been elucidated over the years with no single consensus established but rather sets of criteria. Once a diagnosis has been established the decision of debridement method becomes whether to proceed with single vs two-stage revision based on the probability of infection as well as individual patient factors. After much study, two-stage revision has emerged as the gold standard in the management of periprosthetic infections but single-stage remains prominent with further and further research. Conclusion Despite decades of data, there is no single treatment algorithm for periprosthetic joint infections and subsequent debridement technique. Our review touches on the goals of debridement while providing a perspective as to diagnosis and the particulars of how intraoperative factors such as intraarticular irrigation can play pivotal roles in infection eradication. By providing a perspective on current debridement practices, we hope to encourage future study and debate on how to address periprosthetic joint infections best.

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“…In some retrospective studies, DAIR, together with sensitive antibiotics, was important for treating postoperative SSI [32,33]. Tatarelli et al [34] reported that DAIR is an effective treatment option for early prosthetic joint infections. It has been reported that intervertebral cage exchanged or removed may pose a challenge with an increased risk of neuronal damage and instability [35].…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

Clinical outcome of postoperative surgical site infections in patients with posterior thoracolumbar and lumbar instrumentation

Zhang

Lian

Chen

et al. 2022

Journal of Hospital Infection

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Debridement, antibiotics and implant retention (DAIR): An effective treatment option for early prosthetic joint infections

Cited by 9 publications

References 43 publications

Arthroscopic debridement for infection after fracture fixation (IAFF) of the ankle: A case report

Arthroscopic debridement for infection after fracture fixation (IAFF) of the ankle: A case report

A review of current practices in periprosthetic joint infection debridement and revision arthroplasty

Clinical outcome of postoperative surgical site infections in patients with posterior thoracolumbar and lumbar instrumentation

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