دورية أكاديمية
أعرض في EDS

Outcomes After Successful Debridement, Antibiotic, and Implant Retention Therapy for Periprosthetic Joint Infection in Total Knee Arthroplasty.

التفاصيل البيبلوغرافية
العنوان: Outcomes After Successful Debridement, Antibiotic, and Implant Retention Therapy for Periprosthetic Joint Infection in Total Knee Arthroplasty.
المؤلفون: Van Engen MG; Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa., Carender CN; Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa., Glass NA; Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa., Noiseux NO; Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
المصدر: The Journal of arthroplasty [J Arthroplasty] 2024 Feb; Vol. 39 (2), pp. 483-489. Date of Electronic Publication: 2023 Aug 10.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Taylor and Francis Country of Publication: United States NLM ID: 8703515 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8406 (Electronic) Linking ISSN: 08835403 NLM ISO Abbreviation: J Arthroplasty Subsets: MEDLINE
أسماء مطبوعة: Publication: New Brunswick, NJ : Taylor and Francis
Original Publication: [New York, NY : Churchill Livingstone, c1986-
مواضيع طبية MeSH: Arthroplasty, Replacement, Knee*/adverse effects , Prosthesis-Related Infections*/etiology , Prosthesis-Related Infections*/surgery , Arthritis, Infectious*/etiology, Humans ; Anti-Bacterial Agents/therapeutic use ; Debridement/adverse effects ; Retrospective Studies ; Treatment Outcome
مستخلص: Background: Controversy surrounds debridement, antibiotic and implant retention (DAIR) for treatment of acute periprosthetic joint infection (PJI). Data regarding DAIR's rate of infection resolution is variable with little investigation of functional outcomes.
Methods: We identified 191 DAIR cases at a single institution from 2008 to 2020. Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR) and Patient Reported Outcome Measurement Information System-10 (PROMIS) scores were collected. Patient Reported Outcome Scores were obtained from 60 cases. Median follow-up (IQR) was 4.5 (2.1 to 7.6) versus 3.0 (1.2 to 5.3) years for the control group. Mean scores were compared to a cohort of uncomplicated total knee arthroplasties matched by age, body mass index, and sex using generalized linear models adjusted for follow-up duration. Kaplan-Meier survivorship curves for PJI were constructed.
Results: Mean Patient Reported Outcome Scores for the DAIR cohort were 57.2 ± 19.7 for KOOS-JR, 41.6 ± 7.1 for PROMIS physical health (PH), and 46.6 ± 8.7 for PROMIS mental health (MH). Mean control group values were 65.8 ± 21.0 for KOOS-JR, 44.6 ± 8.4 for PROMIS PH, and 49.2 ± 9.2 for PROMIS MH. No difference was observed in KOOS-JR (P = .83) or PROMIS MH (P = .11). PROMIS PH was lower in the DAIR cohort compared to the control group (P = .048). Median follow-up (years) for all 191 cases was 5.9 (range, 0.5 to 13.1). Survivorship (years) without subsequent operation for infection was 84% at 1, 82% at 2, and 79% at 5.
Conclusion: Knee and MH outcomes in successful DAIR procedures were similar to uncomplicated total knee arthroplasty. DAIR's success rate was 79% in treating acute PJI at 5 years.
Level of Evidence: Level III.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: TKA; debridement; implant retention; infection; outcomes
المشرفين على المادة: 0 (Anti-Bacterial Agents)
تواريخ الأحداث: Date Created: 20230812 Date Completed: 20240108 Latest Revision: 20240108
رمز التحديث: 20240108
DOI: 10.1016/j.arth.2023.08.015
PMID: 37572722
قاعدة البيانات: MEDLINE
الوصف
تدمد:1532-8406
DOI:10.1016/j.arth.2023.08.015