Multiple Irrigation and Debridements for Periprosthetic Joint Infections: Facing a Necessity or Just Prolonging the Inevitable?

J Arthroplasty. 2016 Jan;31(1):219-24. doi: 10.1016/j.arth.2015.06.051. Epub 2015 Jul 2.

Abstract

Irrigation and debridement (I&D) may be a viable option in selected cases of periprosthetic joint infections (PJI). Our aim was to investigate the role of multiple I&Ds. Among 141 patients with PJI treated with I&D in our institution, 19 were subjected to additional procedures. Their clinical characteristics were retrospectively reviewed and compared to the remaining patients treated with a single I&D. The probability of treatment failure (removal of implants) was not significantly different among the two groups. The interval between serial I&Ds was a significant factor determining outcomes. Patients treated with multiple I&Ds had a significantly higher prevalence of peripheral vascular disease. The decision to proceed with repeat of I&D should be made with caution.

Keywords: hip; knee; multiple irrigation and debridements; outcomes; periprosthetic joint infections.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Debridement*
  • Female
  • Hip Prosthesis
  • Humans
  • Knee Prosthesis
  • Male
  • Middle Aged
  • Postoperative Complications
  • Prosthesis-Related Infections / surgery*
  • Retrospective Studies
  • Therapeutic Irrigation*
  • Treatment Failure
  • Treatment Outcome