Timing of debridement, antibiotics, and implant retention for early prosthetic joint infection: data from the Finnish Arthroplasty Register
Syystö, Eetu (2025-10-29)
Timing of debridement, antibiotics, and implant retention for early prosthetic joint infection: data from the Finnish Arthroplasty Register
(29.10.2025)
Julkaisu on tekijänoikeussäännösten alainen. Teosta voi lukea ja tulostaa henkilökohtaista käyttöä varten. Käyttö kaupallisiin tarkoituksiin on kielletty.
avoin
Julkaisun pysyvä osoite on:
https://urn.fi/URN:NBN:fi-fe20251216120098
https://urn.fi/URN:NBN:fi-fe20251216120098
Tiivistelmä
Early periprosthetic joint infection (PJI) is a serious complication of knee and hip replacement with an incidence of around 1 %. It may have disastrous consequences. Debridement, antibiotics and implant retention (DAIR) is the method of choice in the treatment of PJI. Optimal timing of DAIR is somewhat unclear. The aim of this study was to compare the failure rate of DAIR between three time intervals: 0-42 days (=6 weeks), 43-84 (=6-12 weeks) and 85-180 days (=12 weeks-6 months) after the primary total hip arthroplasty and total knee arthroplasty based on Finnish Arthroplasty Register (FAR) data from 2014 to 2022 in 1 year follow-up.
There were 178,498 primary total hip and knee replacements from May 2014 to April 2022 recorded in FAR. A total of 1014 DAIR procedures were performed within 6 months postoperatively. Re-revision due to PJI within one year was regarded as failure of the DAIR treatment. We compared the failure rate of DAIR between three time intervals: 0-42 days, 43-84 and 85-180 days after the primary operation.
After total hip arthroplasty, the failure rate of DAIR was 15.1% when performed within the first 42 days, 10% when done between 43 and 84 days, and 31.4% when carried out 85 to 180 days after the primary surgery. Following total knee arthroplasty, the corresponding failure rates were 8.9%, 16.7%, and 9.8%, respectively. Based on the results, the likelihood of DAIR failure may not increase as much as previously thought when more than six weeks have passed since primary surgery.
There were 178,498 primary total hip and knee replacements from May 2014 to April 2022 recorded in FAR. A total of 1014 DAIR procedures were performed within 6 months postoperatively. Re-revision due to PJI within one year was regarded as failure of the DAIR treatment. We compared the failure rate of DAIR between three time intervals: 0-42 days, 43-84 and 85-180 days after the primary operation.
After total hip arthroplasty, the failure rate of DAIR was 15.1% when performed within the first 42 days, 10% when done between 43 and 84 days, and 31.4% when carried out 85 to 180 days after the primary surgery. Following total knee arthroplasty, the corresponding failure rates were 8.9%, 16.7%, and 9.8%, respectively. Based on the results, the likelihood of DAIR failure may not increase as much as previously thought when more than six weeks have passed since primary surgery.