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Early Debridement, antibiotics and implant retention (DAIR) in patients with suspected acute infection after hip or knee arthroplasty - safe, effective and without negative functional impact

2019Journal article Open access
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dc.contributor.authorBarros, L.
dc.contributor.authorBarbosa, T.
dc.contributor.authorEsteves, J.
dc.contributor.authorAbreu, Mi.
dc.contributor.authorSoares, D.
dc.contributor.authorSousa, Ricardo
dc.date.accessioned2020-05-14T15:47:50Z
dc.date.available2020-05-14T15:47:50Z
dc.date.issued2019
dc.description.abstractIntroduction: Debridement, antibiotics and implant retention (DAIR) is known to be effective in treating acute periprosthetic joint infection (PJI). However, deciding to perform additional surgery in the early postoperative period may be challenging as there is the concern of adding morbidity and clinical presentation is often subtle. We mean to assess the impact of early DAIR on final functional outcome. Methods: A case-control comparison was performed between patients that underwent DAIR for suspected PJI between 2010-2016 and controls randomly selected (1:2 ratio) from a list of primary joint replacements. Patients were matched for anatomic site, age, gender, American Society of Anesthesiologists (ASA) classification, body mass index and follow-up time. The outcome of surgical treatment and complications were assessed and Hip disability and Osteoarthritis Outcome Score (HOOS) or Knee injury and Osteoarthritis Outcome Score (KOOS) were performed. Results: Thirty-eight cases were included at a mean follow-up of 42 months. Infection was not confirmed in one patient. There was one infection related-death and three other cases of treatment failure that required a two-stage revision. Overall success rate was 89.2%. There were no significant patient reported differences regarding final functional outcome between both groups: pain 91±6 vs. 87±13; other symptoms 90±8 vs. 90±9; activities of day living 86±8 vs. 85±14; sport 63±13 vs. 57±16; quality of life 78±17 vs. 76±16. Discussion: These findings support that DAIR for suspected acute PJI is safe, effective and causes no impact on final functional results. Thus, a low threshold for assuming infection and subsequent DAIR may safely be adopted in the early postoperative period.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationBarros LH, Barbosa TA, Esteves J, Abreu M, Soares D, Sousa R. Early Debridement, antibiotics and implant retention (DAIR) in patients with suspected acute infection after hip or knee arthroplasty - safe, effective and without negative functional impact. J Bone Jt Infect. 2019;4(6):300‐305. Published 2019 Dec 10. doi:10.7150/jbji.39168pt_PT
dc.identifier.doi10.7150/jbji.39168pt_PT
dc.identifier.issn2206-3552
dc.identifier.urihttp://hdl.handle.net/10400.16/2393
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherIvyspring International Publisherpt_PT
dc.relation.publisherversionhttp://www.jbji.net/v04p0300.htmpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectacute prosthetic join infectionpt_PT
dc.subjectantibioticspt_PT
dc.subjectdebridementpt_PT
dc.subjectfunctional outcomept_PT
dc.subjectirrigationpt_PT
dc.subjectretentionpt_PT
dc.titleEarly Debridement, antibiotics and implant retention (DAIR) in patients with suspected acute infection after hip or knee arthroplasty - safe, effective and without negative functional impactpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceAustraliapt_PT
oaire.citation.endPage305pt_PT
oaire.citation.issue6pt_PT
oaire.citation.startPage300pt_PT
oaire.citation.titleJournal of bone and joint infectionpt_PT
oaire.citation.volume4pt_PT
person.familyNameSousa
person.givenNameRicardo
person.identifier.ciencia-id8C18-816F-6E4A
person.identifier.orcid0000-0003-4293-7347
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication2f21d3c0-c752-499f-9bcc-d87d9fd31d5c
relation.isAuthorOfPublication.latestForDiscovery2f21d3c0-c752-499f-9bcc-d87d9fd31d5c

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