{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T20:45:42Z","timestamp":1793825142361,"version":"4.6.1"},"reference-count":38,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Debridement with antibiotics and implant retention (DAIR) is commonly utilized for treatment of prosthetic joint infection (PJI) in total knee arthroplasty (TKA), particularly in cases of acute PJI. Reported success rates of DAIR have been highly variable, but the overall success rate of DAIR cohort studies is approximately 70 to 80%. However, no large database studies have investigated the success rate of DAIR. Therefore, we seek to provide a framework for large-database analysis of PJI interventions and their outcomes and to assess the success rate of DAIR. We queried the MarketScan Database for patients who underwent a DAIR (CPT 27310 and\/or CPT 27486) procedure for indication of PJI (ICD-10 T84.53 OR T84.54) between January 1, 2017 and December 31, 2021. We identified reoperations (i.e., stage 1 revision, amputation, or arthrodesis) indicating failure of DAIR. Failure of DAIR treatment was defined by subsequent reoperation. We also identified prescriptions of suppression antibiotics more than 6 months after DAIR. We identified 1,018 patients who underwent a DAIR procedure for PJI. Of these patients, 195 (19.2%) underwent reoperation within 1 year and an additional 178 (17.5%) were prescribed suppressive antibiotics. For 780 patients with a minimum of 2 years of follow-up, 164 (21%) underwent reoperation and an additional 179 (22.9%) were prescribed suppressive antibiotics. Patients with obesity and patients younger than 60 years had significantly higher rates of having reoperation or suppressive antibiotics at 1 year following DAIR. DAIR is a viable option in the treatment of PJI, with an approximately 19% rate of reoperation at 2 years. Our findings are consistent with that of previously published literature.<\/jats:p>","DOI":"10.1055\/a-2501-1024","type":"journal-article","created":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T00:05:21Z","timestamp":1734048321000},"page":"282-289","source":"Crossref","is-referenced-by-count":2,"title":["The Fate of the DAIR, Outcomes after 1 Year: A Large Database Study"],"prefix":"10.1055","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5791-6891","authenticated-orcid":false,"given":"Andrew R.","family":"Grant","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, New England Baptist Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren Z.","family":"Nin","sequence":"additional","affiliation":[{"name":"Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya-Wen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2485-0192","authenticated-orcid":false,"given":"Ruijia","family":"Niu","sequence":"additional","affiliation":[{"name":"Department of Research, New England Baptist Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Esantsi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Tufts Medical Center, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl T.","family":"Talmo","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, New England Baptist Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian L.","family":"Hollenbeck","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, New England Baptist Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C.","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Mattingly","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, New England Baptist Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric L.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Arthroplasty, New England Baptist Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,1,15]]},"reference":[{"issue":"12","key":"ref1","doi-asserted-by":"crossref","first-page":"3783","DOI":"10.1016\/j.arth.2018.08.021","article-title":"Mortality during total knee periprosthetic joint infection","volume":"33","author":"Z C Lum","year":"2018","journal-title":"J Arthroplasty"},{"issue":"24","key":"ref2","doi-asserted-by":"crossref","first-page":"2177","DOI":"10.2106\/JBJS.L.00789","article-title":"Periprosthetic joint infection increases the risk of one-year mortality","volume":"95","author":"B Zmistowski","year":"2013","journal-title":"J Bone Joint Surg Am"},{"issue":"10","key":"ref3","doi-asserted-by":"crossref","first-page":"3238","DOI":"10.1016\/j.arth.2018.05.042","article-title":"Are we winning or losing the battle with periprosthetic joint infection: trends in periprosthetic joint infection and mortality risk for the medicare 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data from the Dutch Arthroplasty Register","volume":"6","author":"B van der Ende","year":"2021","journal-title":"J Bone Jt Infect"},{"issue":"04","key":"ref7","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1302\/0301-620X.104B4.BJJ-2021-1264.R1","article-title":"Debridement, antibiotics, and implant retention after revision arthroplasty : antibiotic mismatch, timing, and repeated DAIR associated with poor outcome","volume":"104-B","author":"K Veerman","year":"2022","journal-title":"Bone Joint J"},{"issue":"04","key":"ref8","doi-asserted-by":"crossref","first-page":"380","DOI":"10.3109\/17453674.2013.823589","article-title":"Prosthetic joint-associated infections treated with DAIR (debridement, antibiotics, irrigation, and retention): analysis of risk factors and local antibiotic carriers in 91 patients","volume":"84","author":"J W Kuiper","year":"2013","journal-title":"Acta 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for the management of infected primary knee arthroplasty in England and Wales: evidence from the National Joint Registry","volume":"11","author":"E Lenguerrand","year":"2022","journal-title":"Bone Joint Res"},{"issue":"01","key":"ref33","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1186\/s12891-021-04044-8","article-title":"One-stage versus two-stage revision of the infected knee arthroplasty: a randomized multicenter clinical trial study protocol","volume":"22","author":"M Lindberg-Larsen","year":"2021","journal-title":"BMC Musculoskelet Disord"},{"issue":"03","key":"ref34","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1111\/iwj.12640","article-title":"Risk factors for periprosthetic joint infection following primary total hip or knee arthroplasty: a meta-analysis","volume":"14","author":"L Kong","year":"2017","journal-title":"Int Wound J"},{"issue":"16","key":"ref35","first-page":"233","article-title":"Patient-related medical risk factors for periprosthetic joint infection of the hip and knee","volume":"3","author":"A Eka","year":"2015","journal-title":"Ann Transl Med"},{"issue":"06","key":"ref36","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1016\/j.arth.2012.01.003","article-title":"The preoperative prediction of success following irrigation and debridement with polyethylene exchange for hip and knee prosthetic joint infections","volume":"27","author":"L T Buller","year":"2012","journal-title":"J Arthroplasty"},{"issue":"14","key":"ref37","doi-asserted-by":"crossref","first-page":"e101","DOI":"10.2106\/JBJS.J.01935","article-title":"Obesity, diabetes, and preoperative hyperglycemia as predictors of periprosthetic joint infection: a single-center analysis of 7181 primary hip and knee replacements for osteoarthritis","volume":"94","author":"E J\u00e4msen","year":"2012","journal-title":"J Bone Joint Surg 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