Journal article
Outcomes after Successful Debridement, Antibiotic, and Implant Retention Therapy for Periprosthetic Joint Infection in Total Knee Arthroplasty
The Journal of arthroplasty, Vol.39(2), pp.483-489
02/2024
DOI: 10.1016/j.arth.2023.08.015
PMID: 37572722
Abstract
Controversy surrounds debridement, antibiotic and implant retention (DAIR) as effective treatment for acute periprosthetic joint infection (PJI). Existing data regarding DAIR's rate of infection resolution is variable with few studies investigating functional outcomes.
We identified 191 DAIR cases at a single institution from 2008 to 2020. Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR) and Patient Reported Outcome Measurement Information System-10 (PROMIS) scores were collected. Patient Reported Outcome Scores (PROS) were obtained from 60 cases with a median follow-up (IQR) of 4.5 (2.1-7.6) versus 3.0 (1.2-5.3) years for the control group. Mean scores were compared to a cohort of uncomplicated total knee arthroplasties (TKA) matched by age, body mass index, and sex using generalized linear models adjusted for follow-up duration. Kaplan Meier survivorship curves for PJI were constructed.
Mean PROS for the DAIR cohort were 57.2±19.7 for Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR), 41.6±7.1 for Patient Reported Outcome Measurement Information System-10 (PROMIS) physical health (PH), and 46.6±8.7 for PROMIS mental health (MH). Mean control group values were 65.8±21.0 for KOOS-JR, 44.6±8.4 for PROMIS PH, and 49.2±9.2 for PROMIS MH. No difference was observed in KOOS-JR (p=0.83) or PROMIS MH (p=0.11). PROMIS PH was lower in the DAIR cohort compared to the control group (p=0.048). Median follow-up (years) for all 191 cases was 5.9 (range, 0.5 to 13.1). Survivorship (years) without subsequent operation for infection was 84% at 1, 82% at 2, and 79% at 5.
Knee and MH outcomes in successful DAIR procedures were similar to uncomplicated TKA. The DAIR success rate was 79% in treating acute PJI at 5 years.
Details
- Title: Subtitle
- Outcomes after Successful Debridement, Antibiotic, and Implant Retention Therapy for Periprosthetic Joint Infection in Total Knee Arthroplasty
- Creators
- Matthew Van Engen - Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, 200 Hawkins Dr, Iowa City, IA, 52246. Electronic address: matthew-vanengen@uiowa.eduChristopher Carender - University of IowaNatalie Glass - University of IowaNicolas Noiseux - University of Iowa
- Resource Type
- Journal article
- Publication Details
- The Journal of arthroplasty, Vol.39(2), pp.483-489
- DOI
- 10.1016/j.arth.2023.08.015
- PMID
- 37572722
- ISSN
- 0883-5403
- eISSN
- 1532-8406
- Language
- English
- Electronic publication date
- 08/10/2023
- Date published
- 02/2024
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984459409902771
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