@article{10902/18918,
year = {2019},
url = {http://hdl.handle.net/10902/18918},
abstract = {Objectives: Debridement, antibiotics and implant retention (DAIR) is the recommended treatment for all acute prosthetic joint infections (PJI), but its efficacy in patients with late acute (LA) PJI is not well described.

Methods: Patients diagnosed with LA PJI between 2005 and 2015 were retrospectively evaluated. LA PJI was defined as the development of acute symptoms (? 3 weeks) occurring ? 3 months after arthroplasty. Failure was defined as: (i) the need for implant removal, (ii) infection related death, (iii) the need for suppressive antibiotic therapy and/or (iv) relapse or reinfection during follow-up.

Results: 340 patients from 27 centers were included. The overall failure rate was 45.0% (153/340). Failure was dominated by Staphylococcus aureus PJI (54.7%, 76/139). Significant independent preoperative risk factors for failure according to the multivariate analysis were: fracture as indication for the prosthesis (odds ratio (OR) 5.4), rheumatoid arthritis (OR 5.1), age above 80 years (OR 2.6), male gender (OR 2.0) and C-reactive protein > 150 mg/L (OR 2.0). Exchanging the mobile components during DAIR was the strongest predictor for treatment success (OR 0.35).

Conclusion: LA PJIs have a high failure rate. Treatment strategies should be individualized according to patients' age, comorbidity, clinical presentation and microorganism causing the infection.},
publisher = {Elsevier},
publisher = {J Infect
. 2019 Jan;78(1):40-47},
title = {Clinical Outcome and Risk Factors for Failure in Late Acute Prosthetic Joint Infections Treated With Debridement and Implant Retention},
author = {Wouthuyzen-Bakker, Marjan and Sebillotte, Marine and Lomas, Jose and Taylor, Adrian and Benavent Palomares, Eva and Murillo, Oscar and Parvizi, Javad and Shohat, Noam and Cobo Reinoso, Javier and Escudero Sánchez, Rosa and Fernández Sampedro, Marta and Senneville, Eric and Huotari, Kaisa and Barbero Allende, José Maria and Garcia-Cañete, Joaquín and Lora-Tamayo, Jaime and Carlo Ferrari, Matteo and Vaznaisiene, Danguole and Yusuf, Erlangga and Aboltins, Craig},
}