Clinical Report: Influence of Timing and Microbial Characteristics on Long-Term Outcomes Following DAIR for Acute Hip PJI

Overview

This study evaluates long-term outcomes of debridement, antibiotics, and implant retention (DAIR) for acute hip periprosthetic joint infection (PJI) in a cohort of 115 patients, identifying clinical, microbiological, and procedural predictors of treatment failure over a mean follow-up of 7.1 years.

Background

Periprosthetic joint infection (PJI) is a significant complication following hip arthroplasty, contributing to a high percentage of revision procedures. The DAIR approach aims to manage acute PJI while preserving the implant, but the long-term success rates and influencing factors remain inadequately studied.

Data Highlights

Key Findings

• DAIR is indicated for infections within three months of prosthesis implantation with specific clinical criteria.
• The study included 115 patients treated with DAIR for acute PJI between January 1999 and May 2018.
• Mean follow-up was 7.1 years, with 3.5% lost to follow-up before five years.
• Infections were classified as early acute (within 4 weeks) and delayed acute (between 5-12 weeks).
• Microbiological characteristics and timing of the DAIR procedure significantly influenced treatment outcomes.

Clinical Implications

The findings suggest that timing of DAIR procedures and microbial characteristics of infections are important factors in treatment outcomes for acute hip PJI.

Conclusion

The study emphasizes the influence of timing and microbial characteristics on long-term outcomes of DAIR for acute hip PJI.

Related Resources & Content

1. Archives of Orthopaedic and Trauma Surgery, 2026 -- High and strikingly early failure-rate following gram-negative periprosthetic joint infection – a retrospective cohort study on 72 cases
2. International Journal of Infectious Diseases, 2026 -- Impact of intraoperative povidone–iodine lavage on 90-day periprosthetic joint infection rates following primary total hip and knee arthroplasty: A retrospective cohort study of 1084 patients
3. Comparative Analysis of Arthroscopic Versus Open Debridement in the Treatment of Acute Periprosthetic Knee Infections
4. JBJI, 2025 -- Debridement, antimicrobial therapy, and implant retention (DAIR) as curative surgical strategy for acute periprosthetic hip and knee infections: a summary of the position paper from the European Bone & Joint Infection Society (EBJIS)
5. Archives of Orthopaedic and Trauma Surgery — Comparative effectiveness of antimicrobial implant surface coatings in preventing orthopaedic implant-associated infections: a network meta-analysis
6. JBJI - Debridement, antimicrobial therapy, and implant retention (DAIR) as curative surgical strategy for acute periprosthetic hip and knee infections: a summary of the position paper from the European Bone & Joint Infection Society (EBJIS)
7. Differences and Similarities in Hip and Knee Acute Periprosthetic Joint Infections After Primary Arthroplasty Treated with Irrigation and Debridement: An International, Multicenter Retrospective Study - The Journal of Arthroplasty