Irrigation and Debridement

doi:10.1002/jor.22556

Cited by 8 publications

(1 citation statement)

References 58 publications

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“…Our experience showed that the key point to success is the aggressiveness of surgical debridement and the surgeon' s ability to reduce the bio burden. All the infected tissues and synovial significant deep areas, synovial and peri-implant tissues must be thoroughly removed 37) . The present literature review with our results shows that debridement, irrigation, antibiotic therapy, change of modular prosthesis components and prosthesis retention is an acceptable solution in the management of early and acute hematogenous PJI of hip.…”

Section: Main Subjectsmentioning

confidence: 99%

Management of Periprosthetic Hip Joint Infection

2015

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Total hip joint replacement offers dramatic improvement in the quality of life but periprosthetic joint infection (PJI) is the most devastating complication of this procedure. The infection threatens the function of the joint, the preservation of the limb, and occasionally even the life of the patient due to long term hospitalization and high cost. For the surgeon it is a disastrous burden, which requires repeated, complicated procedures to eradicate infection and to provide a mobile joint without pain. Yet in the absence of a true gold standard, the diagnosis of PJI can be elusive. Synovial fluid aspiration, diagnostic imaging, traditional culture, peripheral serum inflammatory markers, and intraoperative frozen sections each have their limitations but continue to be the mainstay for diagnosis of PJI. Treatment options mainly include thorough irrigation and debridement with prosthesis retention, or a two-stage prosthesis exchange with intervening placement of an antibiotic-loaded spacer. Success in treating PJI depends on extensive surgical debridement and adequate and effective antibiotic therapy. Treatment in two stages using a spacer is recommended for most chronic PJI. Debridement, antibiotics and implant retention is the obvious choice for treatment of acute PJI, with good success rates in selected patients. This article presents an overview of recent management concepts for PJI of the hip emphasizing diagnosis and the clinical approach, and also share own experience at our institution.

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Section: Main Subjectsmentioning

confidence: 99%

Management of Periprosthetic Hip Joint Infection

2015

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Good quality of life outcomes after treatment of prosthetic joint infection with debridement and prosthesis retention

et al. 2015

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Patients treated for early prosthetic joint infection (PJI) with surgical debridement and prosthesis retention have a rate of successful infection eradication that is similar to patients treated with the traditional approach of prosthesis exchange. It is therefore important to consider other outcomes after prosthetic joint infection treatment that may influence management decisions, such as quality of life (QOL). Our aim was to describe infection cure rates and quality of life for patients with prosthetic joint infection treated with debridement and prosthesis retention and to determine if treatment with this approach was a risk factor for poor quality of life outcomes. Prospectively collected pre and post-arthroplasty data were available for 2,134 patients, of which PJI occurred in 41. For patients treated for prosthetic joint infection, the 2-year survival free of treatment failure was 87% (95%CI 84-89). Prosthetic joint infection cases treated with debridement and retention had a similar improvement from pre-arthroplasty to 12-months postarthroplasty as patients without PJI in QOL according to the SF-12 survey. Prosthetic joint infection treated with debridement and retention was not a risk factor for poor quality of life on univariate or multivariate analysis. Prosthetic joint infection treated with debridement and prosthesis retention results in good cure rates and quality of life. Further studies are required that directly compare quality of life for different surgical approaches for prosthetic joint infection to better inform management decisions.

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DAIR: Concepts and Results (Debridement, Antibiotics, Irrigation, and Implant Retention)

Mohanty

Sathe

2022

Knee Arthroplasty

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Irrigation and Debridement

Cited by 8 publications

References 58 publications

Management of Periprosthetic Hip Joint Infection

Management of Periprosthetic Hip Joint Infection

Good quality of life outcomes after treatment of prosthetic joint infection with debridement and prosthesis retention

DAIR: Concepts and Results (Debridement, Antibiotics, Irrigation, and Implant Retention)

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