Unknown

Dataset Information

0

Fellowship Training in Arthroplasty Improves Treatment Success of Debridement, Antibiotics, and Implant Retention for Periprosthetic Knee Infections.


ABSTRACT:

Background

Debridement, antibiotics, and implant retention (DAIR) is a well-accepted surgical strategy for periprosthetic joint infection (PJI) following total knee arthroplasty (TKA). DAIR in TKA may be incorrectly thought of as a "simple" procedure not requiring formal specialized training in arthroplasty. Currently, there are no studies comparing the risk of treatment failure based on surgeon fellowship training.

Methods

A retrospective review was performed of consecutive patients who underwent DAIR for TKA PJI at our institution. Two cohorts were created based on whether DAIR was performed by an arthroplasty fellowship-trained (FT) surgeon or nonarthroplasty fellowship-trained (NoFT) surgeon. Primary outcome was treatment failure following DAIR at a minimum of 1 year postoperatively. Treatment failure was based on the Tier 1 International Consensus Meeting definition of infection control. Secondary outcomes were also recorded including death during the totality of PJI treatment.

Results

A total of 112 patients were identified (FT = 68, NoFT = 44). At a mean follow-up of 7.3 years [standard deviation = 3.9], 73 patients (59.8%) failed treatment. Fellowship training in arthroplasty significantly improved treatment success rates (FT, 35/68 [51.5%]; NoFT, 10/44 [22.7%]; odds ratio 2.5 [95% confidence interval 1.1 to 5.9; P = .002]). Survivorship also differed significantly between the cohorts; at timepoints of 1.5 months, 5 months, 30 months, and 180 months, survivorship of the FT cohort was 79.4%, 67.6%, 54.4%, and 50.7%, respectively, compared with a survivorship of 65.9%, 52.3%, 25%, and 22.7% in the NoFT cohort (P = .002).

Conclusions

TKA PJI treated with DAIR should not be considered a simple procedure. Improved treatment success may be associated with subspecialty fellowship training in arthroplasty.

Level of evidence

IV.

SUBMITTER: Tubin N 

PROVIDER: S-EPMC11200284 | biostudies-literature | 2024 Jun

REPOSITORIES: biostudies-literature

altmetric image

Publications

Fellowship Training in Arthroplasty Improves Treatment Success of Debridement, Antibiotics, and Implant Retention for Periprosthetic Knee Infections.

Tubin Nicholas N   Brouget-Murray Jonathan J   Bureau Antoine A   Morris Jared J   Azad Marsa M   Abdelbary Hesham H   Grammatopoulos George G   Garceau Simon S  

Arthroplasty today 20240607


<h4>Background</h4>Debridement, antibiotics, and implant retention (DAIR) is a well-accepted surgical strategy for periprosthetic joint infection (PJI) following total knee arthroplasty (TKA). DAIR in TKA may be incorrectly thought of as a "simple" procedure not requiring formal specialized training in arthroplasty. Currently, there are no studies comparing the risk of treatment failure based on surgeon fellowship training.<h4>Methods</h4>A retrospective review was performed of consecutive patie  ...[more]

Similar Datasets

| S-EPMC9355908 | biostudies-literature
| S-EPMC10929323 | biostudies-literature
| S-EPMC11519117 | biostudies-literature
| S-EPMC7045527 | biostudies-literature
| S-EPMC8502838 | biostudies-literature
| S-EPMC10419891 | biostudies-literature
| S-EPMC10929291 | biostudies-literature
| S-EPMC10449712 | biostudies-literature
| S-EPMC9458898 | biostudies-literature
| S-EPMC5858958 | biostudies-literature