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The Fate of the DAIR, Outcomes after 1 Year: A Large Database Study
Andrew R Grant1, Darren Z Nin2, Ya-Wen Chen2
1Department of Orthopaedics, New England Baptist Hospital, Boston, Massachusetts.
The Journal of Knee Surgery
|December 12, 2024
Summary
Debridement with antibiotics and implant retention (DAIR) is a viable treatment for prosthetic joint infection in total knee arthroplasty. This study found a 2-year reoperation rate of approximately 19% for DAIR procedures.
Area of Science:
- Orthopedic surgery
- Infectious disease
Background:
- Prosthetic joint infection (PJI) is a significant complication of total knee arthroplasty (TKA).
- Debridement with antibiotics and implant retention (DAIR) is a common treatment for PJI, especially acute cases.
- Existing success rate data for DAIR is variable and lacks large-database validation.
Purpose of the Study:
- To establish a framework for large-database analysis of PJI interventions.
- To assess the real-world success rate of DAIR in TKA patients using a large database.
Main Methods:
- Utilized the MarketScan Database for patients undergoing DAIR (CPT 27310/27486) for PJI (ICD-10 T84.53/T84.54) from 2017-2021.
- Defined DAIR failure by subsequent reoperation (revision, amputation, arthrodesis) or >6 months of suppressive antibiotics.
- Analyzed reoperation and suppressive antibiotic rates at 1 and 2 years post-DAIR.
Main Results:
- Identified 1,018 patients who underwent DAIR for PJI.
- At 1 year, 19.2% had reoperation and 17.5% received suppressive antibiotics.
- At 2 years (n=780), 21% had reoperation and 22.9% received suppressive antibiotics. Obesity and age <60 were associated with higher failure rates.
Conclusions:
- DAIR demonstrates a viable treatment option for PJI in TKA, with a 2-year reoperation rate around 19%.
- Findings align with previous literature, supporting DAIR's role in PJI management.
- Large-database analysis provides valuable insights into PJI treatment outcomes.
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