Volume 3, 2017
|Number of page(s)||7|
|Published online||11 January 2017|
The DAIR (debridement, antibiotics and implant retention) procedure for infected total knee replacement – a literature review
Orthopaedic Resident, Leicester Orthopaedics, University Hospitals of Leicester, Leicester
LE1 5WW, UK
2 Consultant Microbiologist, University Hospitals of Leicester, Leicester LE1 5WW, UK
3 Consultant Orthopaedic and Sarcoma Surgeon, Leicester Orthopaedics, University Hospitals of Leicester, Leicester LE1 5WW, UK
* Corresponding author: firstname.lastname@example.org
Accepted: 8 November 2016
Prosthetic joint infection (PJI) is a devastating complication in total knee arthroplasty (TKA) and third most common cause of revision of TKA with significant morbidity and surgical challenges. Treatment options include non-operative measures with long term antibiotic suppression, debridement and implant retention (DAIR), one- or two-stage revision arthroplasty, arthrodesis and amputation. Implant retention without infection is ideal and DAIR has been reported to have variable success rates depending on patient factors, duration of infection, infecting micro-organisms, choice of procedure, single or multiple debridement procedures, arthroscopic or open, antibiotic choice and duration of antibiotic use. We present a thorough literature review of DAIR for infected TKA. The important factors contributing to failure are presence of sinus, immunocompromised patient, delay between onset of infection and debridement procedure, Staphylococcal infection in particular Meticillin Resistant Staphylococcal aureus, multiple debridement procedures, retention of exchangeable components and short antibiotic duration. In conclusion DAIR can be successful procedure to eradicate infection in TKA in selective patients with factors contributing to failure taken into account.
Key words: Debridement and implant retention / DAIR / Infected total knee arthroplasty / Prosthetic joint infection
© The Authors, published by EDP Sciences, 2017
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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