{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T10:17:55Z","timestamp":1788171475055,"version":"build-2803163510"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Orthop Surg Traumatol"],"DOI":"10.1007\/s00590-026-04940-6","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T09:51:04Z","timestamp":1788169864000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Antibiotic-loaded calcium sulphate beads in in debridement, antibiotics, and implant retention (DAIR) for acute hip and knee periprosthetic joint infection: a retrospective comparative cohort study"],"prefix":"10.1007","volume":"36","author":[{"given":"Antonio","family":"Pirozzi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Raspanti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niccol\u00f2","family":"Giabbani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Piccica","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Letizia","family":"Attala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9604-2042","authenticated-orcid":false,"given":"Matteo","family":"Innocenti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Mugnaini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1643-9515","authenticated-orcid":false,"given":"Luigi","family":"Zanna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"4940_CR1","doi-asserted-by":"publisher","first-page":"3238","DOI":"10.1016\/j.arth.2018.05.042","volume":"33","author":"SM Kurtz","year":"2018","unstructured":"Kurtz SM, Lau EC, Son M-S et al (2018) Are we winning or losing the battle with periprosthetic joint infection: trends in periprosthetic joint infection and mortality risk for the medicare population. J Arthroplasty 33:3238\u20133245. https:\/\/doi.org\/10.1016\/j.arth.2018.05.042","journal-title":"J Arthroplasty"},{"key":"4940_CR2","doi-asserted-by":"publisher","first-page":"1484","DOI":"10.1016\/j.arth.2020.12.005","volume":"36","author":"A Premkumar","year":"2021","unstructured":"Premkumar A, Kolin DA, Farley KX et al (2021) Projected economic burden of periprosthetic joint infection of the hip and knee in the United States. J Arthroplast 36:1484\u20131489e3. https:\/\/doi.org\/10.1016\/j.arth.2020.12.005","journal-title":"J Arthroplast"},{"key":"4940_CR3","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1302\/0301-620X.105B3.BJJ-2022-0800.R1","volume":"105\u2013B","author":"R Sangaletti","year":"2023","unstructured":"Sangaletti R, Zanna L, Akkaya M et al (2023) Periprosthetic joint infection in patients with multiple arthroplasties: an update on metachronous periprosthetic joint infection. Bone Joint J 105\u2013B:294\u2013300. https:\/\/doi.org\/10.1302\/0301-620X.105B3.BJJ-2022-0800.R1","journal-title":"Bone Joint J"},{"key":"4940_CR4","doi-asserted-by":"publisher","first-page":"1597","DOI":"10.1097\/CORR.0000000000002598","volume":"481","author":"M Akkaya","year":"2023","unstructured":"Akkaya M, Vles G, Sangaletti R et al (2023) What is the safe distance between hip and knee implants to reduce the risk of ipsilateral metachronous periprosthetic joint infection? Clin Orthop Relat Res 481:1597\u20131606. https:\/\/doi.org\/10.1097\/CORR.0000000000002598","journal-title":"Clin Orthop Relat Res"},{"key":"4940_CR5","doi-asserted-by":"publisher","first-page":"2094","DOI":"10.1016\/j.arth.2024.02.053","volume":"39","author":"L Zanna","year":"2024","unstructured":"Zanna L, Lee M, Karlidag T et al (2024) Intramedullary positive tissue culture increases the risk of reinfection following one-stage septic revision total knee arthroplasty. J Arthroplast 39:2094\u20132099. https:\/\/doi.org\/10.1016\/j.arth.2024.02.053","journal-title":"J Arthroplast"},{"key":"4940_CR6","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1128\/CMR.00111-13","volume":"27","author":"AJ Tande","year":"2014","unstructured":"Tande AJ, Patel R (2014) Prosthetic joint infection. Clin Microbiol Rev 27:302\u2013345. https:\/\/doi.org\/10.1128\/CMR.00111-13","journal-title":"Clin Microbiol Rev"},{"key":"4940_CR7","doi-asserted-by":"publisher","first-page":"2257","DOI":"10.1016\/j.arth.2022.05.015","volume":"37","author":"GS Goh","year":"2022","unstructured":"Goh GS, Tarabichi S, Clarkson SJ et al (2022) Positive cultures can be safely ignored in revision arthroplasty patients that do not meet the 2018 international consensus meeting criteria. J Arthroplast 37:2257\u20132261. https:\/\/doi.org\/10.1016\/j.arth.2022.05.015","journal-title":"J Arthroplast"},{"key":"4940_CR8","doi-asserted-by":"publisher","first-page":"128","DOI":"10.2106\/JBJS.H.00155","volume":"91","author":"KJ Bozic","year":"2009","unstructured":"Bozic KJ, Kurtz SM, Lau E et al (2009) The epidemiology of revision total hip arthroplasty in the United States. J Bone Joint Surg Am 91:128\u2013133. https:\/\/doi.org\/10.2106\/JBJS.H.00155","journal-title":"J Bone Joint Surg Am"},{"key":"4940_CR9","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1093\/cid\/cis803","volume":"56","author":"DR Osmon","year":"2013","unstructured":"Osmon DR, Berbari EF, Berendt AR et al (2013) Diagnosis and management of prosthetic joint infection: clinical practice guidelines by the infectious diseases Society of Americaa. Clin Infect Dis 56:e1\u2013e25. https:\/\/doi.org\/10.1093\/cid\/cis803","journal-title":"Clin Infect Dis"},{"key":"4940_CR10","doi-asserted-by":"publisher","first-page":"1645","DOI":"10.1056\/NEJMra040181","volume":"351","author":"W Zimmerli","year":"2004","unstructured":"Zimmerli W, Trampuz A, Ochsner PE (2004) Prosthetic-joint infections. N Engl J Med 351:1645\u20131654. https:\/\/doi.org\/10.1056\/NEJMra040181","journal-title":"N Engl J Med"},{"key":"4940_CR11","doi-asserted-by":"publisher","first-page":"300","DOI":"10.7150\/jbji.39168","volume":"4","author":"LH Barros","year":"2019","unstructured":"Barros LH, Barbosa TA, Esteves J et al (2019) Early Debridement, antibiotics and implant retention (DAIR) in patients with suspected acute infection after hip or knee arthroplasty - safe, effective and without negative functional impact. J Bone Jt Infect 4:300\u2013305. https:\/\/doi.org\/10.7150\/jbji.39168","journal-title":"J Bone Jt Infect"},{"key":"4940_CR12","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1186\/s42836-020-00056-2","volume":"2","author":"Y Xu","year":"2020","unstructured":"Xu Y, Wang L, Xu W (2020) Risk factors affect success rate of debridement, antibiotics and implant retention (DAIR) in periprosthetic joint infection. Arthroplasty 2:37. https:\/\/doi.org\/10.1186\/s42836-020-00056-2","journal-title":"Arthroplasty"},{"key":"4940_CR13","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1016\/j.jinf.2018.07.014","volume":"78","author":"M Wouthuyzen-Bakker","year":"2019","unstructured":"Wouthuyzen-Bakker M, Sebillotte M, Lomas J et al (2019) Clinical outcome and risk factors for failure in late acute prosthetic joint infections treated with debridement and implant retention. J Infect 78:40\u201347. https:\/\/doi.org\/10.1016\/j.jinf.2018.07.014","journal-title":"J Infect"},{"key":"4940_CR14","doi-asserted-by":"publisher","first-page":"510","DOI":"10.1128\/MMBR.00013-14","volume":"78","author":"D Lebeaux","year":"2014","unstructured":"Lebeaux D, Ghigo J-M, Beloin C (2014) Biofilm-related infections: bridging the gap between clinical management and fundamental aspects of recalcitrance toward antibiotics. Microbiol Mol Biol Rev 78:510\u2013543. https:\/\/doi.org\/10.1128\/MMBR.00013-14","journal-title":"Microbiol Mol Biol Rev"},{"key":"4940_CR15","doi-asserted-by":"publisher","first-page":"1128","DOI":"10.1016\/j.arth.2013.12.012","volume":"29","author":"KL Urish","year":"2014","unstructured":"Urish KL, DeMuth PW, Craft DW et al (2014) Pulse lavage is inadequate at removal of biofilm from the surface of total knee arthroplasty materials. J Arthroplasty 29:1128\u20131132. https:\/\/doi.org\/10.1016\/j.arth.2013.12.012","journal-title":"J Arthroplasty"},{"key":"4940_CR16","doi-asserted-by":"publisher","first-page":"605","DOI":"10.3390\/pathogens12040605","volume":"12","author":"PF Indelli","year":"2023","unstructured":"Indelli PF, Ghirardelli S, Valpiana P et al (2023) Debridement, antibiotic pearls, and retention of the implant (DAPRI) in the treatment of early periprosthetic joint infections: a consecutive series. Pathogens 12:605. https:\/\/doi.org\/10.3390\/pathogens12040605","journal-title":"Pathogens"},{"key":"4940_CR17","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1089\/sur.2013.162","volume":"16","author":"SS Aiken","year":"2015","unstructured":"Aiken SS, Cooper JJ, Florance H et al (2015) Local release of antibiotics for surgical site infection management using high-purity calcium sulfate: an in vitro elution study. Surg Infect 16:54\u201361. https:\/\/doi.org\/10.1089\/sur.2013.162","journal-title":"Surg Infect"},{"key":"4940_CR18","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1177\/0885328216663392","volume":"31","author":"JJ Cooper","year":"2016","unstructured":"Cooper JJ, Florance H, McKinnon JL et al (2016) Elution profiles of tobramycin and vancomycin from high-purity calcium sulphate beads incubated in a range of simulated body fluids. J Biomater Appl 31:357\u2013365. https:\/\/doi.org\/10.1177\/0885328216663392","journal-title":"J Biomater Appl"},{"key":"4940_CR19","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1016\/j.artd.2022.01.023","volume":"14","author":"TD Tarity","year":"2022","unstructured":"Tarity TD, Xiang W, Jones CW et al (2022) Do antibiotic-loaded calcium sulfate beads improve outcomes after debr idement, antibiotics, and implant retention? A Matched Cohort Study. Arthroplasty Today 14:90\u201395. https:\/\/doi.org\/10.1016\/j.artd.2022.01.023","journal-title":"Arthroplasty Today"},{"key":"4940_CR20","doi-asserted-by":"publisher","first-page":"707","DOI":"10.2340\/17453674.2024.42360","volume":"95","author":"IK Sigmund","year":"2024","unstructured":"Sigmund IK, Palmer AJR, Hotchen AJ et al (2024) The use of antibiotic-loaded calcium sulphate beads in debridement, antibiotics, and implant retention (DAIR) for periprosthetic infections: a retrospective comparative cohort on outcome. Acta Orthop 95:707\u2013714. https:\/\/doi.org\/10.2340\/17453674.2024.42360","journal-title":"Acta Orthop"},{"key":"4940_CR21","doi-asserted-by":"publisher","first-page":"2505","DOI":"10.1016\/j.arth.2017.03.051","volume":"32","author":"MA Flierl","year":"2017","unstructured":"Flierl MA, Culp BM, Okroj KT et al (2017) Poor outcomes of irrigation and debridement in acute periprosthetic joint infection with antibiotic-impregnated calcium sulfate beads. J Arthroplast 32:2505\u20132507. https:\/\/doi.org\/10.1016\/j.arth.2017.03.051","journal-title":"J Arthroplast"},{"key":"4940_CR22","doi-asserted-by":"publisher","first-page":"11","DOI":"10.5194\/jbji-7-11-2022","volume":"7","author":"K Reinisch","year":"2022","unstructured":"Reinisch K, Schl\u00e4ppi M, Meier C, Wahl P (2022) Local antibiotic treatment with calcium sulfate as carrier material im proves the outcome of debridement, antibiotics, and implant retention procedures for periprosthetic joint infections after hip arthroplasty - a retrospective study. J Bone Joint Infect 7:11\u201321. https:\/\/doi.org\/10.5194\/jbji-7-11-2022","journal-title":"J Bone Joint Infect"},{"key":"4940_CR23","doi-asserted-by":"publisher","first-page":"2823","DOI":"10.1007\/s00167-019-05627-8","volume":"28","author":"Y Gramlich","year":"2020","unstructured":"Gramlich Y, Johnson T, Kemmerer M et al (2020) Salvage procedure for chronic periprosthetic knee infection: the application of DAIR results in better remission rates and infection-free survivorship when used with topical degradable calcium-based antibiotics. Knee Surg Sports Traumatol Arthrosc 28:2823\u20132834. https:\/\/doi.org\/10.1007\/s00167-019-05627-8","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"4940_CR24","doi-asserted-by":"publisher","first-page":"1309","DOI":"10.1016\/j.arth.2018.02.078","volume":"33","author":"J Parvizi","year":"2018","unstructured":"Parvizi J, Tan TL, Goswami K et al (2018) The 2018 definition of periprosthetic hip and knee infection: an evidence-based and validated criteria. J Arthroplasty 33:1309\u20131314e2. https:\/\/doi.org\/10.1016\/j.arth.2018.02.078","journal-title":"J Arthroplasty"},{"key":"4940_CR25","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1016\/S0140-6736(14)61798-0","volume":"387","author":"BH Kapadia","year":"2016","unstructured":"Kapadia BH, Berg RA, Daley JA et al (2016) Periprosthetic joint infection. Lancet 387:386\u2013394. https:\/\/doi.org\/10.1016\/S0140-6736(14)61798-0","journal-title":"Lancet"},{"key":"4940_CR26","doi-asserted-by":"publisher","first-page":"1991","DOI":"10.1056\/NEJMoa2020198","volume":"384","author":"L Bernard","year":"2021","unstructured":"Bernard L, Arvieux C, Brunschweiler B et al (2021) Antibiotic therapy for 6 or 12 weeks for prosthetic joint infection. N Engl J Med 384:1991\u20132001. https:\/\/doi.org\/10.1056\/NEJMoa2020198","journal-title":"N Engl J Med"},{"key":"4940_CR27","doi-asserted-by":"publisher","first-page":"2374","DOI":"10.1007\/s11999-013-2866-1","volume":"471","author":"C Diaz-Ledezma","year":"2013","unstructured":"Diaz-Ledezma C, Higuera CA, Parvizi J (2013) Success after treatment of periprosthetic joint infection: a delphi-based international multidisciplinary consensus. Clin Orthop Relat Res 471:2374\u20132382. https:\/\/doi.org\/10.1007\/s11999-013-2866-1","journal-title":"Clin Orthop Relat Res"},{"key":"4940_CR28","doi-asserted-by":"publisher","first-page":"277","DOI":"10.5194\/jbji-11-277-2026","volume":"11","author":"D Di Costa","year":"2026","unstructured":"Di Costa D, Capece G, Coppola D et al (2026) The use of debridement, antibiotic pearls, and implant retention (DAPRI) in the management of acute periprosthetic joint infections: a systematic review. J Bone Joint Infect 11:277\u2013285. https:\/\/doi.org\/10.5194\/jbji-11-277-2026","journal-title":"J Bone Joint Infect"},{"key":"4940_CR29","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1016\/j.arth.2020.07.081","volume":"36","author":"MF Zhu","year":"2021","unstructured":"Zhu MF, Kim K, Cavadino A et al (2021) Success rates of debridement, antibiotics, and implant retention in 230 infected total knee arthroplasties: implications for classification of periprosthetic joint infection. J Arthroplasty 36:305\u2013310e1. https:\/\/doi.org\/10.1016\/j.arth.2020.07.081","journal-title":"J Arthroplasty"},{"key":"4940_CR30","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1007\/s12178-018-9497-9","volume":"11","author":"DA Zaruta","year":"2018","unstructured":"Zaruta DA, Qiu B, Liu AY, Ricciardi BF (2018) Indications and guidelines for debridement and implant retention for periprosthetic hip and knee infection. Curr Rev Musculoskelet Med 11:347\u2013356. https:\/\/doi.org\/10.1007\/s12178-018-9497-9","journal-title":"Curr Rev Musculoskelet Med"},{"key":"4940_CR31","doi-asserted-by":"publisher","first-page":"1906","DOI":"10.1016\/j.arth.2020.02.017","volume":"35","author":"C Xu","year":"2020","unstructured":"Xu C, Tan TL, Li WT, Goswami K, Parvizi J (2020) Reporting outcomes of treatment for periprosthetic joint infection of the knee and hip together with a minimum 1-year follow-up is reliable. J Arthroplasty 35:1906\u20131911. https:\/\/doi.org\/10.1016\/j.arth.2020.02.017","journal-title":"J Arthroplasty"}],"container-title":["European Journal of Orthopaedic Surgery & Traumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00590-026-04940-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00590-026-04940-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00590-026-04940-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T09:51:05Z","timestamp":1788169865000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00590-026-04940-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,31]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4940"],"URL":"https:\/\/doi.org\/10.1007\/s00590-026-04940-6","relation":{},"ISSN":["1432-1068"],"issn-type":[{"value":"1432-1068","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,31]]},"assertion":[{"value":"25 June 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 August 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 August 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"358"}}