Polymicrobial Infection Is Associated with Failure of DAIR in Acute Hip Periprosthetic Joint Infection

Area of Science:

• Orthopedic Surgery
• Infectious Diseases
• Arthroplasty Management

Background:

• Debridement, antibiotics, and implant retention (DAIR) is a standard approach for acute periprosthetic joint infection (PJI) after hip arthroplasty.
• Optimal patient selection and understanding predictors of DAIR failure remain critical challenges.

Purpose of the Study:

• To evaluate the effectiveness of DAIR for acute hip PJI.
• To identify predictors of treatment failure in patients undergoing DAIR for hip PJI.

Main Methods:

• Retrospective cohort study of 48 patients with acute hip PJI treated with DAIR.
• Analysis of clinical characteristics, comorbidities, microbiology, and perioperative variables.
• Multivariable logistic regression and ROC curve analysis to identify failure predictors.

Main Results:

• DAIR achieved infection control in 83.3% of cases at a mean follow-up of 23.7 months.
• Polymicrobial infection was significantly associated with higher treatment failure rates (p=0.049).
• An exploratory predictive model showed good discriminatory performance (AUC=0.87) for DAIR outcome.

Conclusions:

• DAIR is effective for carefully selected acute hip PJI patients.
• Polymicrobial infections warrant consideration of alternative surgical strategies.
• Exploratory risk models may aid preoperative decisions, requiring validation in larger studies.