Periprosthetic knee infections treated with irrigation and debridement: outcomes and preoperative predictive factors

J Arthroplasty. 2015 Apr;30(4):649-57. doi: 10.1016/j.arth.2014.10.026. Epub 2014 Oct 25.

Abstract

The role of irrigation and debridement (I&D) in the treatment of periprosthetic joint infections (PJI) of the knee remains controversial. Our purpose was to identify the success rate and factors determining outcome of I&D in those patients. Clinical characteristics of 78 patients with PJI of the knee treated with I&D were retrospectively reviewed. Implant retention at final follow-up was achieved in 43 patients (55.1%). Logistic regression analysis revealed that duration of symptoms >5days and thyroid disease were independent predictors of I&D failure. Patients with methicillin-resistant staphylococcal infections had a success rate of 45.5% and significantly lower odds of success compared to patients with negative cultures. In selected patients, I&D is a reasonable option in the context of acute PJI of the knee.

Keywords: debridement; irrigation; knee; outcomes; periprosthetic joint infections; predictive factors.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use*
  • Body Mass Index
  • Debridement*
  • Female
  • Humans
  • Knee Joint
  • Male
  • Middle Aged
  • Preoperative Period
  • Prosthesis-Related Infections / drug therapy*
  • Regression Analysis
  • Retrospective Studies
  • Therapeutic Irrigation*
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents