We used the criteria established by the Musculoskeletal Infection Society (MSIS) to diagnose infection. Patient consent and approval from the institutional research ethics board were obtained. We performed a retrospective study of all the patients diagnosed with an acute postoperative or acute hematogenous periprosthetic joint infection (PJI) after TKA who underwent DAIR at our institution during the period between 20. The goal of this study was to assess the clinical and radiological results following this therapeutic option, to identify possible predictors of outcome and to compare the outcomes between hematogenous and acute periprosthetic knee infections. In the current literature, controversy remains as to whether DAIR should be performed for both acute postoperative and acute hematogenous infections, or just in the acute ones, since a substantial number of patients with acute hematogenous infections ultimately experience a relapse of infection after this less-aggressive procedure. However, its success rate varies widely in the literature (18–100%), depending on the factors of the patient, duration of infection, microorganisms involved, debridement technique, type of antibiotic, and duration of the antibiotherapy. In case of acute postoperative and acute hematogenous infections of TKA, DAIR is one of the treatments of choice. The gold standard for treating deep chronic infections is two-stage reimplantation since these infections are very difficult to control with debridement and irrigation with prosthetic retention followed by antibiotic therapy (DAIR). It is estimated that its incidence is between 1 and 2% after primary prosthesis and up to 5–6% in revision surgery. Infection after total knee arthroplasty (TKA) is one of the most devastating complications and one of the most frequent causes of revision, together with aseptic loosening and instability. The present study shows a considerable cure rate in the treatment of acute knee infections through DAIR, although patient comorbidities, type of infection, and causative microorganism should be considered for decision-making. The infections in which the Staphylococcus aureus was isolated had a significantly lower cure rate, with only 33% of success, compared to 82% of the non-aureus microorganisms ( p < 0.05). The overall success rate was 77% at the last follow-up, recording a significantly greater cure in acute infections (93% acute vs 58% acute hematogenous, p = 0.03). Moreover, univariate cox regression analysis was performed. A descriptive analysis was carried out on the collected data, and a univariate analysis was performed with the objective of searching for influential factors in the resolution of the infection using the chi-square nonparametric test in the case of the categorical variables and the Wilcoxon test for the continuous ones. Several variables related to patient characteristics, infection type, and surgery were examined to evaluate their influence on outcome, and functional and radiographic outcome were assessed. Overall, 26 knees were included, with a mean age of 73.4 years. We retrospectively reviewed cases of acute postoperative (≤ 3 months from index procedure) and acute hematogenous periprosthetic knee infections treated with DAIR at our hospital between 20. The goal of this study was to assess the outcomes of this therapeutic option and to identify possible predictors of the result. However, the success rate varies widely in the literature, depending on several factors such as comorbidities of the patient, duration of infection, and microorganisms involved. Debridement and irrigation with prosthetic retention followed by antibiotic therapy (DAIR) is one of the treatments of choice in acute infections after a total knee arthroplasty.
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