Research progress on debridement, antibiotics, and implant retention (DAIR) for the treatment of periprosthetic joint infection after artificial joint replacement - Summary - MDSpire
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Advancements in Debridement, Antibiotic Therapy, and Implant Preservation (DAIR) for Managing Periprosthetic Joint Infections Following Joint Replacement Surgery
To evaluate the indications, influencing factors, and technical advancements of DAIR to improve treatment success rates.
Approach:
Timing of Debridement: DAIR is recommended for acute postoperative PJI and acute hematogenous PJI, ideally performed within 4 weeks of symptom onset.
Key Findings:
DAIR success rates exceed 80% when performed within 90 days of surgery.
Delays beyond one month significantly reduce DAIR success rates.
Obesity, diabetes, and immunosuppression are critical risk factors for PJI.
Interpretation:
Early diagnosis and timely intervention are crucial for maximizing the effectiveness of DAIR.
Limitations:
Real-world effectiveness of DAIR may be lower than reported success rates from specialized centers.
Conclusion:
DAIR is a time-sensitive treatment that can preserve implants and improve patient outcomes when applied early and with consideration of patient-specific factors.
A systematic review of more than 2.3 million patients found that women and men had different patterns of postoperative complications and recovery, with age and implant strategy modifying observed differences.
