RT Journal Article
T1 Implant Removal in the Management of Prosthetic Joint Infection by Staphylococcus aureus: Outcome and Predictors of Failure in a Large Retrospective Multicenter Study.
A1 Gómez-Junyent, Joan
A1 Lora-Tamayo, Jaime
A1 Baraia-Etxaburu, Josu
A1 Sánchez-Somolinos, Mar
A1 Iribarren, Jose Antonio
A1 Rodriguez-Pardo, Dolors
A1 Praena-Segovia, Julia
A1 Sorlí, Luisa
A1 Bahamonde, Alberto
A1 Riera, Melchor
A1 Rico, Alicia
A1 Del Toro, Mª Dolores
A1 Morata, Laura
A1 Cobo, Javier
A1 Falgueras, Luis
A1 Benito, Natividad
A1 Muñez, Elena
A1 Jover-Sáenz, Alfredo
A1 Pigrau, Carles
A1 Ariza, Javier
A1 Murillo, Oscar
K1 Staphylococcus aureus
K1 implant removal
K1 outcome
K1 prosthetic joint infection
K1 rifampin
AB To compare the characteristics and outcomes of cases with acute prosthetic joint infection (PJI; early post-surgical or hematogenous) by Staphylococcus aureus managed with implant removal (IRm) or debridement and retention (DAIR). To analyze the outcomes of all cases managed with IRm (initially or after DAIR failure). Retrospective, multicenter, cohort study of PJI by S. aureus (2003-2010). Overall failure included mortality within 60 days since surgery and local failure due to staphylococcal persistence/relapse. 499 cases, 338 initially managed with DAIR, 161 with IRm. Mortality was higher in acute PJI managed initially with IRm compared to DAIR, but not associated with the surgical procedure, after propensity score matching. Underlying conditions, hemiarthroplasty, and methicillin-resistant S. aureus were risk factors for mortality. Finally, 249 cases underwent IRm (88 after DAIR failure); overall failure was 15.6%. Local failure (9.3%) was slightly higher in cases with several comorbidities, but independent of previous DAIR, type of IRm, and rifampin treatment. In a large multicenter study of S. aureus PJI managed with IRm, failure was low, but mortality significant, especially in cases with acute PJI and underlying conditions, but not associated with the IRm itself. Rifampin efficacy was limited in this setting.
SN 2079-6382
YR 2021
FD 2021-01-26
LK http://hdl.handle.net/10668/17087
UL http://hdl.handle.net/10668/17087
LA en
DS RISalud
RD Apr 8, 2025