Efficacy of Adjunctive Antiseptic Lavage Solution in Managing Acute Hip/Knee Prosthetic Joint Infection: A Comparative Study in a Tertiary Revision Center

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today Pub Date : 2025-02-01 DOI:10.1016/j.artd.2024.101593

Jonathan Quinn FRACS , Bernard H. van Duren DPhil, FRCS , Reshid Berber PhD, FRCS , Mark Higgins FRCS , Hosam E. Matar FRCS , Andrew R. Manktelow FRCS , Benjamin V. Bloch FRCS

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引用次数: 0

Abstract

Background

Debridement, antibiotics and implant retention (DAIR) procedure is well-established as a management option for acute periprosthetic joint infection (PJI). We investigated the infection eradication rates of DAIR procedures at our center using Bactisure wound lavage.

Methods

A retrospective consecutive review of DAIR procedures for hip and knee PJI was conducted between 2018 and 2023 with a minimum 12-month follow-up at our tertiary revision arthroplasty center. Suitability for DAIR was determined at the multi-disciplinary team discussion. Revision procedures and patients with previous PJI were excluded. Patient, surgical, microbiological, and postoperative data (minimum 12 months) was reviewed. The use of Bactisure was in addition to routine surgical management.

Results

During the study period, 76 DAIR procedures were performed (55 knees and 21 hips). Bactisure was used in 26 cases (20 knees and 6 hips). Overall, 6 of 26 Bactisure DAIRs failed (23%), while 14 of 50 non-Bactisure DAIRs failed (28%), which did not demonstrate statistical significance (P = .644). Subgroup analysis demonstrated no difference in knee DAIRs (P = .761) but a trend toward significance in hip DAIRs (P = .262). No adverse effects of Bactisure use were noted intraoperatively or postoperatively. DAIR failed in 50% of diabetic patients compared to 20% of nondiabetic patients (P = .015). Age, body mass index, and organism identification did not influence outcome.

Conclusions

The addition of Bactisure to DAIR procedures did not demonstrate statistically significant improvement of successful eradication of infection, but a potential trend toward significance was noted in hip DAIRs. Diabetic patients failed DAIR in 50% of cases. The in-vivo outcomes of Bactisure use during DAIR procedures remain inconclusive.

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来源期刊

Arthroplasty Today Medicine-Surgery

CiteScore

2.90

自引率

0.00%

发文量

258

审稿时长

40 weeks

期刊介绍： Arthroplasty Today is a companion journal to the Journal of Arthroplasty. The journal Arthroplasty Today brings together the clinical and scientific foundations for joint replacement of the hip and knee in an open-access, online format. Arthroplasty Today solicits manuscripts of the highest quality from all areas of scientific endeavor that relate to joint replacement or the treatment of its complications, including those dealing with patient outcomes, economic and policy issues, prosthetic design, biomechanics, biomaterials, and biologic response to arthroplasty. The journal focuses on case reports. It is the purpose of Arthroplasty Today to present material to practicing orthopaedic surgeons that will keep them abreast of developments in the field, prove useful in the care of patients, and aid in understanding the scientific foundation of this subspecialty area of joint replacement. The international members of the Editorial Board provide a worldwide perspective for the journal''s area of interest. Their participation ensures that each issue of Arthroplasty Today provides the reader with timely, peer-reviewed articles of the highest quality.