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Current Reviews in Musculoskeletal Medicine

Erschienen in:

05.06.2018 | Prosthetic Joint Infection (S Nodzo and N Frisch, section editors)

Indications and Guidelines for Debridement and Implant Retention for Periprosthetic Hip and Knee Infection

verfasst von: Douglas A. Zaruta, Bowen Qiu, Andrew Y. Liu, Benjamin F. Ricciardi

Erschienen in: Current Reviews in Musculoskeletal Medicine | Ausgabe 3/2018

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Abstract

Purpose of Review

Prosthetic joint infection is one the most common causes of revision surgery after hip or knee replacement. Debridement and implant retention (DAIR) is one method of treating these infections; however, significant controversy exists. The purpose of our review was to describe current knowledge about indications, intraoperative/postoperative patient management, and outcomes of DAIR.

Recent Findings

Patient selection affects the success of DAIR. Medical comorbidities, duration of symptoms, and nature of infectious organism all influence outcomes. Intraoperative techniques such as open arthrotomy, extensive debridement, copious irrigation, and exchange of modular parts remain current standards for DAIR. Postoperative administration of antibiotics tailored to operative cultures remains critical. Antibiotic suppression may increase the success of DAIR.

Summary

DAIR provides reasonable infection eradication between 50 and 80% with improved outcomes in appropriately selected patients. More research is needed on the use of adjuvant therapies intraoperatively and the role of postoperative antibiotic suppression.

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Titel: Indications and Guidelines for Debridement and Implant Retention for Periprosthetic Hip and Knee Infection
verfasst von: Douglas A. Zaruta
Bowen Qiu
Andrew Y. Liu
Benjamin F. Ricciardi
Publikationsdatum: 05.06.2018
Verlag: Springer US
Erschienen in: Current Reviews in Musculoskeletal Medicine / Ausgabe 3/2018
Elektronische ISSN: 1935-9748
DOI: https://doi.org/10.1007/s12178-018-9497-9

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