Wouthuyzen-Bakker, MarjanSebillotte, MarineLomas, JoseKendrick, BenjaminPalomares, Eva BenaventMurillo, OscarParvizi, JavadShohat, NoamReinoso, Javier CoboSánchez, Rosa EscuderoFernandez-Sampedro, MartaSenneville, EricHuotari, KaisaAllende, José Maria BarberoGarcía, Antonio BlancoLora-Tamayo, JaimeFerrari, Matteo CarloVaznaisiene, DanguoleYusuf, ErlanggaAboltins, CraigTrebse, RihardSalles, Mauro JoséBenito, NatividadVila, AndreaToro, Maria Dolores DelKramer, Tobias SiegfriedPetersdorf, SabineDiaz-Brito, VicensTufan, Zeliha KocakSanchez, MarisaArvieux, CédricSoriano, AlexESCMID Study Group for Implant-Associated Infections (ESGIAI)2023-01-252023-01-252019-07-15http://hdl.handle.net/10668/14254We evaluated the treatment outcome in late acute (LA) periprosthetic joint infections (PJI) treated with debridement and implant retention (DAIR) versus implant removal. In a large multicenter study, LA PJIs of the hip and knee were retrospectively evaluated. Failure was defined as: PJI related death, prosthesis removal or the need for suppressive antibiotic therapy. LA PJI was defined as acute symptoms 445 patients were included, comprising 340 cases treated with DAIR and 105 cases treated with implant removal (19% one-stage revision (n = 20), 74.3% two-stage revision (n = 78) and 6.7% definitive implant removal (n = 7). Overall failure in patients treated with DAIR was 45.0% (153/340) compared to 24.8% (26/105) for implant removal (p  DAIR is a viable surgical treatment for most patients with LA PJI, but implant removal should be considered in a subset of patients, especially in those with a CRIME80-score ≥3.enDebridementFailureHematogenousLate acutePeriprosthetic joint infectionRevision surgeryAgedAged, 80 and overAlgorithmsArthritis, InfectiousBiomarkersDevice RemovalDisease ManagementFemaleHumansMalePropensity ScoreProstheses and ImplantsProsthesis-Related InfectionsRetrospective StudiesSeverity of Illness IndexSurvival AnalysisTreatment Outcomeresearch article31319141open access10.1016/j.jinf.2019.07.0031532-2742https://helda.helsinki.fi/bitstream/10138/320939/1/1_s2.0_S0163445319301987_main.pdf