Debridement, Antibiotics and Implant Retention: A Systematic Review of Strategies for Treatment of Early Infections after Revision Total Knee Arthroplasty
Publication year
2023Source
Journal of Clinical Medicine, 12, 15, (2023), pp. 5026, article 5026ISSN
Publication type
Article / Letter to editor
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Organization
Orthopaedics
Journal title
Journal of Clinical Medicine
Volume
vol. 12
Issue
iss. 15
Page start
p. 5026
Subject
Radboudumc 10: Reconstructive and regenerative medicine Orthopaedics; Orthopaedics - Radboud University Medical CenterAbstract
GOAL: The purpose of this review is to provide a systematic and comprehensive overview of the available literature on the treatment of an early prosthetic joint infection (PJI) after revision total knee arthroplasty (TKA) and provide treatment guidelines. METHODS: This systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The search was conducted using the electronic databases of PubMed, Trip, Cochrane, Embase, LILACS and SciElo. After the inclusion of the relevant articles, we extracted the data and results to compose a treatment algorithm for early and acute PJI after revision TKA. RESULTS: After applying the in- and exclusion criteria, seven articles were included in this systematic review focusing on debridement, antibiotics and implant retention (DAIR) for PJI following revision TKA, of which one was prospective and six were retrospective. All studies were qualified as level IV evidence. CONCLUSIONS: The current literature suggests that DAIR is a valid treatment option for early infections after revision TKA with success rates of 50-70%. Repeat DAIR shows success rates of around 50%. Further research should be aimed at predicting successful (repeat/two-stage) DAIRs in larger study populations, antibiotic regimes and the cost effectiveness of a second DAIR after revision TKA.
This item appears in the following Collection(s)
- Academic publications [246216]
- Electronic publications [133894]
- Faculty of Medical Sciences [93266]
- Open Access publications [107422]
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