RT Journal Article
T1 Clinical outcome and risk factors for failure in late acute prosthetic joint infections treated with debridement and implant retention.
A1 Wouthuyzen-Bakker, Marjan
A1 Sebillotte, Marine
A1 Lomas, Jose
A1 Taylor, Adrian
A1 Benavent-Palomares, Eva
A1 Murillo, Oscar
A1 Parvizi, Javad
A1 Shohat, Noam
A1 Cobo-Reinoso, Javier
A1 Escudero-Sanchez, Rosa
A1 Fernandez-Sampedro, Marta
A1 Senneville, Eric
A1 Huotari, Kaisa
A1 Barbero, Jose Maria
A1 Garcia-Cañete, Joaquin
A1 Lora-Tamayo, Jaime
A1 Ferrari, Matteo Carlo
A1 Vaznaisiene, Danguole
A1 Yusuf, Erlangga
A1 Aboltins, Craig
A1 Trebse, Rihard
A1 Salles, Mauro Jose
A1 Benito, Natividad
A1 Vila, Andrea
A1 Del-Toro, Maria Dolores
A1 Kramer, Tobias Siegfried
A1 Petersdorf, Sabine
A1 Diaz-Brito, Vicens
A1 Tufan, Zeliha Kocak
A1 Sanchez, Marisa
A1 Arvieux, Cedric
A1 Soriano, Alex
K1 Acute
K1 Hematogenous
K1 Prosthetic joint infection
K1 Risk factors, failure
AB Debridement, antibiotics and implant retention (DAIR) is the recommended treatment for all acute prosthetic joint infections (PJI), but its efficacy in patients with late acute (LA) PJI is not well described. Patients diagnosed with LA PJI between 2005 and 2015 were retrospectively evaluated. LA PJI was defined as the development of acute symptoms (≤ 3 weeks) occurring ≥ 3 months after arthroplasty. Failure was defined as: (i) the need for implant removal, (ii) infection related death, (iii) the need for suppressive antibiotic therapy and/or (iv) relapse or reinfection during follow-up. 340 patients from 27 centers were included. The overall failure rate was 45.0% (153/340). Failure was dominated by Staphylococcus aureus PJI (54.7%, 76/139). Significant independent preoperative risk factors for failure according to the multivariate analysis were: fracture as indication for the prosthesis (odds ratio (OR) 5.4), rheumatoid arthritis (OR 5.1), age above 80 years (OR 2.6), male gender (OR 2.0) and C-reactive protein > 150 mg/L (OR 2.0). Exchanging the mobile components during DAIR was the strongest predictor for treatment success (OR 0.35). LA PJIs have a high failure rate. Treatment strategies should be individualized according to patients' age, comorbidity, clinical presentation and microorganism causing the infection.
PB Elsevier Ltd
YR 2018
FD 2018-08-07
LK http://hdl.handle.net/10668/12816
UL http://hdl.handle.net/10668/12816
LA en
NO Wouthuyzen-Bakker M, Sebillotte M, Lomas J, Taylor A, Palomares EB, Murillo O, et al. Clinical outcome and risk factors for failure in late acute prosthetic joint infections treated with debridement and implant retention. J Infect. 2019 Jan;78(1):40-47.
DS RISalud
RD Apr 5, 2025