RT Journal Article
T1 Lower Success Rate of Débridement and Implant Retention in Late Acute versus Early Acute Periprosthetic Joint Infection Caused by Staphylococcus spp. Results from a Matched Cohort Study.
A1 Wouthuyzen-Bakker, Marjan
A1 Sebillotte, Marine
A1 Huotari, Kaisa
A1 Escudero Sánchez, Rosa
A1 Benavent, Eva
A1 Parvizi, Javad
A1 Fernandez-Sampedro, Marta
A1 Barbero, José Maria
A1 Garcia-Cañete, Joaquín
A1 Trebse, Rihard
A1 Del Toro, Maria
A1 Diaz-Brito, Vicens
A1 Sanchez, Marisa
A1 Scarborough, Matthew
A1 Soriano, Alex
A1 ESCMID Study Group for Implant-Associated Infections (ESGIAI), 
AB Surgical débridement, antibiotics and implant retention (DAIR) is currently recommended by international guidelines for both early acute (postsurgical) and late acute (hematogenous) periprosthetic joint infections (PJIs). However, due to a different pathogenesis of infection, a different treatment strategy may be needed. (1) Compared with early acute PJIs, are late acute PJIs associated with a higher risk of DAIR failure? (2) When stratified by microorganism, is the higher risk of failure in late acute PJI associated with Staphylocococcus aureus infection? (3) When analyzing patients with S. aureus infection, what factors are independently associated with DAIR failure? In this multicenter observational study, early acute and late acute PJIs treated with DAIR were retrospectively evaluated and matched according to treating center, year of diagnosis, and infection-causing microorganism. If multiple matches were available, the early acute PJI diagnosed closest to the late acute PJI was selected. A total of 132 pairs were included. Treatment success was defined as a retained implant during follow-up without the need for antibiotic suppressive therapy. Late acute PJIs had a lower treatment success (46% [60 of 132]) compared with early acute PJIs (76% [100 of 132]), OR 3.9 [95% CI 2.3 to 6.6]; p  Although DAIR seems to be a successful therapeutic strategy in the management of early acute PJI, its use in late acute PJI should be reconsidered when caused by Staphylococcus spp. Our results advocate the importance of isolating the causative microorganism before surgery. Level III, therapeutic study.
YR 2020
FD 2020
LK http://hdl.handle.net/10668/15174
UL http://hdl.handle.net/10668/15174
LA en
DS RISalud
RD Apr 8, 2025