![]() ![]() A similar classification describes early (3 months), delayed/low-grade (3–24 months), and late infection (> 24 months) (Trampuz and Zimmerli Citation2005). Generally, PJIs are classified in 3 groups, based on duration of symptoms and time after surgery: (I) early postoperative: symptoms less than 4 weeks after surgery (II) late chronic: a gradual, indolent onset of symptoms or (III) acute hematogenous: acute onset in a previously well-functioning prosthesis (Tsukayama et al. Infected artificial joints are often unresponsive to antibiotic treatment, due to poor vascular supply and biofilm formation. Citation2008, Del Pozo and Patel Citation2009). Prosthetic joint-associated infection (PJI) occurs in around 1–2% of primary total hip arthroplasties (THAs) and total knee arthroplasties (TKAs) (Trampuz and Zimmerli Citation2005, Kurtz et al. Interpretation In the presence of rheumatoid arthritis, duration of symptoms of more than 1 week, ESR above 60 mm/h, late infection (> 2 years after arthroplasty), and coagulase-negative Staphylococcus PJI, the chances of successful DAIR treatment decrease, and other treatment methods should be considered. Less surgical procedures were performed in the group treated with sponges than in the group treated with beads. The use of gentamicin sponges was statistically significantly higher in the success group, and the use of beads was higher in the failure group in the univariate analysis, but these differences did not reach significance in the logistic regression analysis. Symptom duration of less than 1 week was associated with treatment success. Factors associated with treatment failure were: a history of rheumatoid arthritis, late infection (> 2 years after arthroplasty), ESR at presentation above 60 mm/h, and infection caused by coagulase-negative Staphylococcus. ![]() Results 60 patients (66%) were free of infection at follow-up. Treatment success was defined as absence of infection after 2 years, with retention of the prosthesis and without the use of suppressive antibiotics. Patients and methods 91 patients treated with DAIR for hip or knee PJI in 3 Dutch centers between 20 were retrospectively evaluated. We retrospectively analyzed risk factors in a cohort of patients from 3 hospitals, treated with DAIR for PJI. The use of local antibiotic carriers (beads and sponges) is relatively unknown. Various risk factors associated with treatment success have been described. Background and purpose For prosthetic joint-associated infection (PJI), a regimen of debridement, antibiotics, irrigation, and retention of the prosthesis (DAIR) is generally accepted for acute infections. ![]()
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