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

<h3>Purpose</h3><p dir="ltr">This 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.</p><h3>Meth...

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Main Author: Loay A. Salman (14150322) (author)
Other Authors: Seif B. Altahtamouni (22155577) (author), Harman Khatkar (17765961) (author), Abdallah Al-Ani (10687939) (author), Ghalib Ahmed (14146800) (author)
Published: 2024
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author Loay A. Salman (14150322)
author2 Seif B. Altahtamouni (22155577)
Harman Khatkar (17765961)
Abdallah Al-Ani (10687939)
Ghalib Ahmed (14146800)
author2_role author
author
author
author
author_facet Loay A. Salman (14150322)
Seif B. Altahtamouni (22155577)
Harman Khatkar (17765961)
Abdallah Al-Ani (10687939)
Ghalib Ahmed (14146800)
author_role author
dc.creator.none.fl_str_mv Loay A. Salman (14150322)
Seif B. Altahtamouni (22155577)
Harman Khatkar (17765961)
Abdallah Al-Ani (10687939)
Ghalib Ahmed (14146800)
dc.date.none.fl_str_mv 2024-09-02T03:00:00Z
dc.identifier.none.fl_str_mv 10.1007/s00590-024-04091-6
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/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/30023728
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
Arthroplasty
Knee
Hip
Periprosthetic joint infection
dc.title.none.fl_str_mv 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
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3>Purpose</h3><p dir="ltr">This 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.</p><h3>Methods</h3><p dir="ltr">Four 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.</p><h3>Results</h3><p dir="ltr">A 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/m<sup>2</sup> (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 (<i>p</i> = 0.740). Additionally, the success rate for triple DAIR ranged from 50 to 60%.</p><h3>Conclusion</h3><p dir="ltr">This 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.</p><h2>Other Information</h2><p dir="ltr">Published in: European Journal of Orthopaedic Surgery & Traumatology<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1007/s00590-024-04091-6" target="_blank">https://dx.doi.org/10.1007/s00590-024-04091-6</a></p>
eu_rights_str_mv openAccess
id Manara2_6a14d0f9ccb562277ce7da620722a63f
identifier_str_mv 10.1007/s00590-024-04091-6
network_acronym_str Manara2
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oai_identifier_str oai:figshare.com:article/30023728
publishDate 2024
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rights_invalid_str_mv CC BY 4.0
spelling Success rate of single versus multiple debridement, antibiotics, and implant retention (DAIR) in hip and knee periprosthetic joint infection: a systematic review and meta-analysisLoay A. Salman (14150322)Seif B. Altahtamouni (22155577)Harman Khatkar (17765961)Abdallah Al-Ani (10687939)Ghalib Ahmed (14146800)Biomedical and clinical sciencesClinical sciencesArthroplastyKneeHipPeriprosthetic joint infection<h3>Purpose</h3><p dir="ltr">This 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.</p><h3>Methods</h3><p dir="ltr">Four 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.</p><h3>Results</h3><p dir="ltr">A 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/m<sup>2</sup> (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 (<i>p</i> = 0.740). Additionally, the success rate for triple DAIR ranged from 50 to 60%.</p><h3>Conclusion</h3><p dir="ltr">This 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.</p><h2>Other Information</h2><p dir="ltr">Published in: European Journal of Orthopaedic Surgery & Traumatology<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1007/s00590-024-04091-6" target="_blank">https://dx.doi.org/10.1007/s00590-024-04091-6</a></p>2024-09-02T03:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1007/s00590-024-04091-6https://figshare.com/articles/journal_contribution/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/30023728CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/300237282024-09-02T03:00:00Z
spellingShingle 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
Loay A. Salman (14150322)
Biomedical and clinical sciences
Clinical sciences
Arthroplasty
Knee
Hip
Periprosthetic joint infection
status_str publishedVersion
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Biomedical and clinical sciences
Clinical sciences
Arthroplasty
Knee
Hip
Periprosthetic joint infection