Debridement, antibiotics, irrigation and retention in prosthetic joint infection : predictive tools of failure

Keywords:

Hip arthroplasty ; periprosthetic joint infection ; debridement and irrigation ; failure


Published online: Apr 16 2021

Daniel Morcillo, Christine Detrembleur, Hervé Poilvache, Maïté Van Cauter, Jean Cyr Yombi, Olivier Cornu

From the Cliniques Universitaires Saint-Luc, Bruxelles

Abstract

Debridement, antibiotic, irrigation and retention of the implant (DAIR) is an attractive treatment for periprosthetic joint infection (PJI). The purpose of this study is to determine predictive factors of failure. We reviewed all DAIR procedures for hip PJI performed between 2002-2017 (n=69). Data recorded included all factors correlated with treatment failure. KLIC score, McPherson adapted score were analyzed. Infection eradication for early PJI (< 4 weeks) was achieved in 68% of patients and was correlated with treatment success (p=0.01). KLIC score (p=0.036), McPherson adapted score (p=0.01), CRP (p=0.025) and late PJI (p=0.031) were significantly predictive of failure treatment. We have established an equation in order to predict failure treatment that has to be validated.

DAIR is an effective treatment for early PJI. KLIC score and McPherson adapted score are two ways to predict outcome of a DAIR procedure and should help making the decision in PJI treatment.