We need a new acronym supplementing DAIR: Introducing DECRA

Area of Science:

• Orthopaedic surgery
• Infectious disease research
• Biomedical engineering

Background:

• Acute Periprosthetic Joint Infection (PJI) treatment historically uses DAIR (Debridement, Antibiotics, Implant Retention).
• The DAIR acronym does not specify whether modular implant components are exchanged.
• Modular exchange in DAIR procedures is associated with improved outcomes but is not always feasible or consistently reported.

Purpose of the Study:

• To introduce a supplementary acronym, DECRA (Debridement, Modular Exchange, Component Retention, Antibiotics), for acute PJI treatment.
• To differentiate PJI treatment studies that consistently involve modular exchange from those that do not or are unclear.
• To reduce heterogeneity in research literature and improve the fidelity of analysis for PJI treatment outcomes.

Main Methods:

• Literature review and conceptual framework development.
• Proposal of the DECRA acronym as a distinct classification for PJI treatment protocols.
• Advocacy for adoption by the orthopaedic community, reviewers, and editors.

Main Results:

• The introduction of the DECRA acronym provides a clear distinction for studies involving mandatory modular exchange in acute PJI treatment.
• This distinction separates DECRA from DAIR, where modular exchange is not performed or is unclarified.
• The proposed acronym aims to reduce heterogeneity and enhance the precision of research analysis in the field of PJI management.

Conclusions:

• The DECRA acronym offers a precise method for classifying acute PJI treatments that include modular exchange.
• Adoption of DECRA will improve the clarity and comparability of research findings on PJI management.
• Mindful application of this distinction by the orthopaedic community is crucial for advancing treatment strategies and research integrity.