<scp>E</scp>arly prosthetic hip joint infection treated with debridement, prosthesis retention and biofilm‐active antibiotics: functional outcomes, quality of life and complications

Aboltins, Craig; Dowsey, Michelle M.; Peel, Trisha; Lim, Wen Kwang; Parikh, Sumit; Stanley, Peter; Choong, Peter F. M.

doi:10.1111/imj.12174

Cited by 33 publications

(52 citation statements)

References 20 publications

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“…A total of 11 studies reporting on 292 cases could be identified ( Figure 1) [2][3][6][7][8][9][10][11][12][13][14] . Two studies were published before and nine after 2000.…”

Section: Researchmentioning

confidence: 99%

“…One study [10] reported on debridement and another on debridement and irrigation [12] . Six studies performed debridement, lavage and change of modular prosthesis components (polyethylene (PE) liner, femoral stem head) [2,3,6,7,9,14] , whereas in one of these studies the PE liner was not changed in all patients [9] . One study combined this procedure along with the use of the vacuum-assisted closure therapy [11] .…”

Section: Researchmentioning

confidence: 99%

“…Although single studies demonstrated high success rate exceeding 90%, the relative small number of patients treated as well as the low level of evidence does not allow for generalization of [7] 2013 19 All early 1 Ⅲ Anagnostakos et al [8] 2010…”

mentioning

confidence: 99%

“…[12] 89.6% (26/29) [8,13] 92.8% (26/28) [11] 70.4% (126/179) [2,3,6,7,9,14] ing factors identified no difference between methicillinsensitive and methicillin-resistant staphylococcus or head/liner exchange and no exchange [9] . These findings are contradictory to the general acceptance that prosthesis retention is feasible at the site of early infection with a short duration of symptoms.…”

mentioning

confidence: 99%

“…The only risk factor associated with failure of infection control at the latest follow-up was the S. aureus microorganism. Additional subgroup analysis to identify other possible contribut- Aboltins et al [6] Debridement, lavage, 1/13 aseptic prosthesis loosening 92.30% Change of PE-liner [Median = 1 (1-4)] Aboltins et al [7] Debridement, lavage, N.c.d. 89.50% Change of PE-liner [Median = 3 (3-6)] Anagnostakos et al [8] Acetabular cup removal + 2/12 draining sinus 91.60% Spacer head onto retained stem After spacer head implantation; Mean implantation period 88 (35-270) d 1/12 spacer dislocation; 3/12 prosthesis dislocation Choi et al [9] 19/28 debridement, irrigation, 5/28 staged revision, 50% Change of PE-liner 6/28 repeated debridement, 9/28 debridement, irrigation, 4/28 resection arthroplasty No change of PE-liner Crockarell et al [10] Debridement 1/42 prosthesis dislocation, 21% 1 1/42 periprosthetic femoral fracture, 1/42 exitus due to sepsis Kelm et al [11] Debridement, pulsatile lavage, None 92.80% Change of PE-liner, Vacuum-assisted closure Klouche et al [12] Debridement, irrigation n.r.…”

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confidence: 99%

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Can periprosthetic hip joint infections be successfully managed by debridement and prosthesis retention?

Anagnostakos

Schmitt

2014

WJO

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To evaluate the current literature about how successfully periprosthetic hip joint infections can be managed by debridement and prosthesis retention. A literature search was performed through PubMed until September 2013. Search terms were "DAIR (debridement, antibiotics, irrigation, and retention)" alone and in combination with "hip" as well as "hip infection + prosthesis retention". A total of 11 studies reporting on 292 cases could be identified. Five different treatment modalities have been described with varying success rates (debridement-21% infection eradication rate; debridement + lavage-75% infection eradication rate; debridement, lavage, with change of modular prosthesis components-70.4% infection eradication rate; debridement, lavage, change of modular prosthesis components + vacuum-assisted closure-92.8% infection eradication rate; acetabular cup removal + spacer head onto retained stem-89.6% infection eradication rate). With regard to the postoperative antibiotic therapy, no general consensus could be drawn from the available data. Debridement, antibiotic therapy, irrigation, and prosthesis retention is an acceptable solution in the management of early and acute hematogenous periprosthetic hip joint infections. The current literature does not allow for generalization of conclusions with regard to the best treatment modality. A large, multi-center study is required for identification of the optimal treatment of these infections.

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“…A total of 11 studies reporting on 292 cases could be identified ( Figure 1) [2][3][6][7][8][9][10][11][12][13][14] . Two studies were published before and nine after 2000.…”

Section: Researchmentioning

confidence: 99%

Section: Researchmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Can periprosthetic hip joint infections be successfully managed by debridement and prosthesis retention?

Anagnostakos

Schmitt

2014

WJO

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Therapie der periprothetischen Infektion

Renner

Perka

Trampuž

et al. 2016

Chirurg

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The increasing number of prosthesis implantations and higher life expectancy lead to a growing number of periprosthetic infections (PPI). Optimal therapy necessitates interdisciplinary coordination of surgical and antimicrobial treatment. Challenges in the treatment are the increased occurrence of resistant pathogens, selection of adequate antimicrobial and surgical treatment strategies, inappropriate pretreatment and comorbidities of patients. Current treatment concepts lead to a high success rate in terms of infection eradication, when correctly applied. The individual expectations and underlying conditions of each patient must be considered when determining the therapy concept. The first step is to distinguish between acute and chronic infections. In acute infections the prosthesis can be retained but chronic infections necessitate a complete exchange of the prosthesis. Complicating factors, such as compromising soft tissue and bone conditions, osteomyelitis and infections caused by difficult-to-treat bacteria should, however, always be treated by a complete exchange of the prosthesis, even for acute infections. The antimicrobial treatment must be tailored to the causative agent, the surgical strategy as well as comorbidities and drug intolerances of the patient. It is important to distinguish between biofilm-active eradication therapy with rifampicin for gram-positive pathogens and quinolones for gram-negative organisms and suppression therapy. This article gives a structured presentation of the therapy algorithm.

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Predicting Failure in Early Acute Prosthetic Joint Infection Treated With Debridement, Antibiotics, and Implant Retention: External Validation of the KLIC Score

Löwik

Jutte

Tornero

et al. 2018

The Journal of Arthroplasty

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Early prosthetic hip joint infection treated with debridement, prosthesis retention and biofilm‐active antibiotics: functional outcomes, quality of life and complications

Abstract: Key words

Cited by 33 publications

References 20 publications

Can periprosthetic hip joint infections be successfully managed by debridement and prosthesis retention?

Can periprosthetic hip joint infections be successfully managed by debridement and prosthesis retention?

Therapie der periprothetischen Infektion

Predicting Failure in Early Acute Prosthetic Joint Infection Treated With Debridement, Antibiotics, and Implant Retention: External Validation of the KLIC Score

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