Clinical trial NCT02087020: Debridement, Antibiotics and Implant Retention in Early Periprosthetic Joint Infection: A Retrospective Cohort Study
Official title: Debridement, Antibiotics and Implant Retention in Early Periprosthetic Joint Infection: A Retrospective Cohort Study
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Direct Infection of Hip- and Knee Arthroplasty
Keywords: Joint Prosthesis
Prosthesis-Related Infections
Joint Diseases
Therapeutic Irrigation
Prostheses and Implants
Arthroplasty Replacement
Lead sponsor: Danderyd Hospital
Sponsor class: OTHER
First posted: 2014-03-14
Enrollment: 51
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Danderyd Hospital is a university hospital affiliated with the Karolinska Institute and is one of the four emergency hospitals in Stockholm, with a catchment area of approximately 500.000 inhabitants. The index cohort was extracted from the local in-hospital surgery database at the Department of Orthopaedic Surgery using ICD 10 coding and surgical intervention coding for PJI treatment.

Brief summary: Introduction: Periprosthetic joint infection (PJI) is a common cause for reoperation after knee and hip arthroplasty surgery. Debridement, antibiotics and implant retention (DAIR) is recommended in early infections (\< 4 weeks) and stable implants. Aims: To define the success rate of DAIR in early infections and to identify predictors for success. Material and methods: In a retrospective cohort study we included patients with hip- or knee arthroplasties reoperated for an early PJI at Danderyd Hospital 2007-2012. Logistic regression analysis was used to identify risk factors affecting success rate. Primary outcome variable was the success of the DAIR treatment. Secondary outcome variable vas risk factors for treatment failure.


Eligibility criteria: Inclusion Criteria:

Patients treated with DAIR for early postoperative periprosthetic joint infection after knee- or hip arthroplasty surgery (\<4-6 weeks postoperatively) at our institution between 2007-01-01 and 2012-12-01.

Exclusion Criteria:

Chronic or late presenting periprosthetic joint infection (\>6 weeks postoperatively), acute hematogenous periprosthetic joint infection, when the periprosthetic joint infection diagnosis criteria according to American Musculoskeletal Infection Society (MSIS) 2011 definition of PJI definitions were not fulfilled and when the initial surgical treatment was with other treatment protocol than DAIR including one-stage revision and two -stage revision

Primary outcomes:
measure: Successful treatment
timeFrame: 6 year
Secondary outcomes:
measure: Risk factors for treatment failure
timeFrame: 6 year
Other outcomes:
Locations:
city: Stockholm
country: Sweden
facility: Danderyd Hospital
state: Danderyd
Study officials:
affiliation: Orthopaedic department, Danderyds hospital
name: Olof G Skoldenberg, MD,PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: Orthopaedic department, Danderyds hospital
name: Sebastian S Mukka, MD
role: STUDY_CHAIR
References:
citation: Zimmerli W, Trampuz A, Ochsner PE. Prosthetic-joint infections. N Engl J Med. 2004 Oct 14;351(16):1645-54. doi: 10.1056/NEJMra040181. No abstract available.
citation: Bergkvist M, Mukka SS, Johansson L, Ahl TE, Sayed-Noor AS, Skoldenberg OG, Eisler T. Debridement, antibiotics and implant retention in early periprosthetic joint infection. Hip Int. 2016 Mar-Apr;26(2):138-43. doi: 10.5301/hipint.5000328. Epub 2016 Feb 8.