Success rate of single versus multiple debridement, antibiotics, and implant retention (DAIR) in hip and knee periprosthetic joint infection: a systematic review and meta-analysis

被引:1
作者
Salman, Loay A. [1 ,4 ]
Altahtamouni, Seif B. [1 ]
Khatkar, Harman [2 ]
Al-Ani, Abdallah [3 ]
Ahmed, Ghalib [1 ]
机构
[1] Hamad Med Corp, Hamad Gen Hosp, Orthoped Surg Dept, POB 3050, Doha, Qatar
[2] Royal London Hosp, London, England
[3] King Hussein Canc Ctr, Off Sci Affairs & Res, Amman, Jordan
[4] Hamad Med Corp, Surg Specialty Ctr, Dept Orthopaed Surg, Doha, Qatar
关键词
Arthroplasty; Knee; Hip; Periprosthetic joint infection; ARTHROPLASTY; IRRIGATION; EXCHANGE; MANAGEMENT; RESISTANCE;
D O I
10.1007/s00590-024-04091-6
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
PurposeThis systematic review aimed to compare outcomes between multiple and single debridement, antibiotics, and implant retention (DAIR) procedures for early periprosthetic joint infection (PJI) in hip and knee arthroplasty.MethodsFour databases were searched from inception till January 2024 for original studies investigating the outcomes of multiple DAIR in hip and knee PJI. The primary outcome was the success rate in eradicating joint infection. This review was conducted per PRISMA guidelines.ResultsA total of 9 observational studies with 1104 participants were included, with a mean age and BMI of 58.37 years (95%CI: 25.77-90.98) and 31.43 kg/m2 (95%CI: 28.89-34.98), respectively. The mean follow-up period was 58.37 months (95%CI: 25.77-90.98), and the average MINORS score assigned to the review was 17.6 +/- 3.46, indicating a low overall risk of bias. An equivalent success rate between single and double DAIR was observed, at 67% (95%CI: 64-71%) and 70% (95%CI: 48-86%), respectively, with no statistically significant difference between the two treatment modalities (p = 0.740). Additionally, the success rate for triple DAIR ranged from 50 to 60%.ConclusionThis study suggests that double DAIR is a valid treatment option for acute PJI after TKA and THA, with a success rate comparable to single DAIR (70% vs. 67%, p = 0.740). Triple DAIR achieved success rates ranging from 50 to 60%. However, caution is warranted when interpreting these results due to heterogeneity in host comorbidity factors, DAIR protocols, and antibiotic regimens.Level of EvidenceTherapeutic, Level III.
引用
收藏
页码:3859 / 3872
页数:14
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