Andrew Ryan Grant, Darren Nin, Ya-Wen Chen, Ruijia Niu, Michael Esantsi, Carl Talmo, Brian Hollenbeck, David Chang, David Mattingly, Eric L Smith
{"title":"DAIR 的命运,一年后的结果:大型数据库研究。","authors":"Andrew Ryan Grant, Darren Nin, Ya-Wen Chen, Ruijia Niu, Michael Esantsi, Carl Talmo, Brian Hollenbeck, David Chang, David Mattingly, Eric L Smith","doi":"10.1055/a-2501-1024","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Debridement with antibiotics and implant retention (DAIR) is commonly utilized for prosthetic joint infection (PJI) for total knee arthroplasty (TKA); particularly in cases of acute PJI 1. Reported success rates of DAIR have been highly variable, but the overall success rate of DAIR cohort studies is ~70-80% 2. However, no large database studies have investigated the success rate of DAIR. Therefore, we seek to provide a framework for large-database analysis of PJI interventions and their outcomes and to assess the success rate of DAIR. Methods We queried the MarketScan Database for patients who underwent a DAIR (CPT 27310 and/or CPT 27486) procedure for indication of PJI (ICD-10 T84.53 OR T84.54) between 1/1/2017 to 12/31/2021. We identified reoperations (i.e. Stage-1 revision, amputation, or arthrodesis) indicating failure of DAIR. Failure of DAIR treatment was defined by subsequent reoperation. We also identified prescriptions of suppression antibiotics more than 6 months after DAIR 3. Results We identified 1018 patients who underwent a DAIR procedure for PJI. Of these patients, 195 (19.2%) underwent reoperation within one year and an additional 178 (17.5%) were prescribed suppressive antibiotics. For 780 patients with a minimum of two years of follow up, 164 (21%) underwent reoperation and an additional 179 (22.9%) were prescribed suppressive antibiotics. Patients with obesity and patients under age 60 had significantly higher rates of having reoperation or suppressive antibiotics at one year following DAIR. Conclusion DAIR is a viable option in the treatment of PJI with an approximately 19% rate of reoperation at two years. Our findings are consistent with that of previously published literature.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Fate of the DAIR, Outcomes After One Year: a large database study.\",\"authors\":\"Andrew Ryan Grant, Darren Nin, Ya-Wen Chen, Ruijia Niu, Michael Esantsi, Carl Talmo, Brian Hollenbeck, David Chang, David Mattingly, Eric L Smith\",\"doi\":\"10.1055/a-2501-1024\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Debridement with antibiotics and implant retention (DAIR) is commonly utilized for prosthetic joint infection (PJI) for total knee arthroplasty (TKA); particularly in cases of acute PJI 1. Reported success rates of DAIR have been highly variable, but the overall success rate of DAIR cohort studies is ~70-80% 2. However, no large database studies have investigated the success rate of DAIR. Therefore, we seek to provide a framework for large-database analysis of PJI interventions and their outcomes and to assess the success rate of DAIR. Methods We queried the MarketScan Database for patients who underwent a DAIR (CPT 27310 and/or CPT 27486) procedure for indication of PJI (ICD-10 T84.53 OR T84.54) between 1/1/2017 to 12/31/2021. We identified reoperations (i.e. Stage-1 revision, amputation, or arthrodesis) indicating failure of DAIR. Failure of DAIR treatment was defined by subsequent reoperation. We also identified prescriptions of suppression antibiotics more than 6 months after DAIR 3. Results We identified 1018 patients who underwent a DAIR procedure for PJI. Of these patients, 195 (19.2%) underwent reoperation within one year and an additional 178 (17.5%) were prescribed suppressive antibiotics. For 780 patients with a minimum of two years of follow up, 164 (21%) underwent reoperation and an additional 179 (22.9%) were prescribed suppressive antibiotics. Patients with obesity and patients under age 60 had significantly higher rates of having reoperation or suppressive antibiotics at one year following DAIR. Conclusion DAIR is a viable option in the treatment of PJI with an approximately 19% rate of reoperation at two years. Our findings are consistent with that of previously published literature.</p>\",\"PeriodicalId\":48798,\"journal\":{\"name\":\"Journal of Knee Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-12-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Knee Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1055/a-2501-1024\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Knee Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/a-2501-1024","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
The Fate of the DAIR, Outcomes After One Year: a large database study.
Introduction: Debridement with antibiotics and implant retention (DAIR) is commonly utilized for prosthetic joint infection (PJI) for total knee arthroplasty (TKA); particularly in cases of acute PJI 1. Reported success rates of DAIR have been highly variable, but the overall success rate of DAIR cohort studies is ~70-80% 2. However, no large database studies have investigated the success rate of DAIR. Therefore, we seek to provide a framework for large-database analysis of PJI interventions and their outcomes and to assess the success rate of DAIR. Methods We queried the MarketScan Database for patients who underwent a DAIR (CPT 27310 and/or CPT 27486) procedure for indication of PJI (ICD-10 T84.53 OR T84.54) between 1/1/2017 to 12/31/2021. We identified reoperations (i.e. Stage-1 revision, amputation, or arthrodesis) indicating failure of DAIR. Failure of DAIR treatment was defined by subsequent reoperation. We also identified prescriptions of suppression antibiotics more than 6 months after DAIR 3. Results We identified 1018 patients who underwent a DAIR procedure for PJI. Of these patients, 195 (19.2%) underwent reoperation within one year and an additional 178 (17.5%) were prescribed suppressive antibiotics. For 780 patients with a minimum of two years of follow up, 164 (21%) underwent reoperation and an additional 179 (22.9%) were prescribed suppressive antibiotics. Patients with obesity and patients under age 60 had significantly higher rates of having reoperation or suppressive antibiotics at one year following DAIR. Conclusion DAIR is a viable option in the treatment of PJI with an approximately 19% rate of reoperation at two years. Our findings are consistent with that of previously published literature.
期刊介绍:
The Journal of Knee Surgery covers a range of issues relating to the orthopaedic techniques of arthroscopy, arthroplasty, and reconstructive surgery of the knee joint. In addition to original peer-review articles, this periodical provides details on emerging surgical techniques, as well as reviews and special focus sections. Topics of interest include cruciate ligament repair and reconstruction, bone grafting, cartilage regeneration, and magnetic resonance imaging.