Di Benedetto Paolo, Di Benedetto Enrico Daniele, Salviato Daniele, Beltrame Alessandro, Gissoni Renato, Cainero Vanni, Causero Araldo
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Acta Biomed. 2017 Jun 7;88(2S):84-91. doi: 10.23750/abm.v88i2-S.6518.
Periprosthetic knee infection is a rare complication associated with prosthetic failure; incidence change from 0,4-2% of primary total knee replacement and 5.6% in revisions. Indications for debridment, antibiotics and implant retention (DAIR) are early acute infections or acute delayed infection. Aim of the work is to check if this technique is still a successful in early infections.
We have analyzed recent literature data on DAIR and all DAIR procedures in our clinic in the last 10 years, the mean time between onset of symptoms and surgery, the mean antibiotic therapy duration and results we have obtained. We evaluate the diagnostic process and different treatments in early knee periprosthetic infections, especially the DAIR approach.
If correct indications are followed, DAIR has a success rate in 31-100% of the cases; if it is applied in late chronic infection the success rate is 28-62%. In our experience DAIR has an 80% success rate: in 20 patients treated with DAIR we had 4 failures.
DAIR can be considered a successful treatment, but it depends from individual patient factors, from the microorganisms involved, from the duration of antibiotic therapy and from correct choice in timing and in execution of DAIR by the orthopedic surgeon.
人工膝关节周围感染是一种与假体失败相关的罕见并发症；在初次全膝关节置换中发生率为0.4%-2%，在翻修手术中为5.6%。清创、抗生素及保留植入物（DAIR）的适应证为早期急性感染或急性延迟感染。本研究的目的是检验该技术在早期感染中是否仍然有效。
我们分析了近期关于DAIR的文献数据以及过去10年我们诊所所有的DAIR手术，包括症状出现至手术的平均时间、平均抗生素治疗时长以及我们所获得的结果。我们评估了早期人工膝关节周围感染的诊断过程和不同治疗方法，尤其是DAIR方法。
如果遵循正确的适应证，DAIR在31%-100%的病例中有成功率；如果应用于晚期慢性感染，成功率为28%-62%。根据我们的经验，DAIR的成功率为80%：在20例接受DAIR治疗的患者中，有4例失败。
DAIR可被视为一种成功的治疗方法，但它取决于个体患者因素、所涉及的微生物、抗生素治疗时长以及骨科医生在DAIR时机选择和实施上的正确抉择。
