{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T00:50:05Z","timestamp":1790988605373,"version":"4.1.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2019,8,31]],"date-time":"2019-08-31T00:00:00Z","timestamp":1567209600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,7,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The success of debridement, antibiotics, and implant retention (DAIR) in early periprosthetic joint infection (PJI) largely depends on the presence of a mature biofilm. At what time point DAIR should be disrecommended is unknown. This multicenter study evaluated the outcome of DAIR in relation to the time after index arthroplasty.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We retrospectively evaluated PJIs occurring within 90 days after surgery and treated with DAIR. Patients with bacteremia, arthroscopic debridements, and a follow-up &amp;lt;1 year were excluded. Treatment failure was defined as (1) any further surgical procedure related to infection; (2) PJI-related death; or (3) use of long-term suppressive antibiotics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We included 769 patients. Treatment failure occurred in 294 patients (38%) and was similar between time intervals from index arthroplasty to DAIR: the failure rate for Week 1\u20132 was 42% (95\/226), the rate for Week 3\u20134 was 38% (143\/378), the rate for Week 5\u20136 was 29% (29\/100), and the rate for Week 7\u201312 was 42% (27\/65). An exchange of modular components was performed to a lesser extent in the early post-surgical course compared with the late course (41% vs 63%, respectively; P &amp;lt; .001). The causative microorganisms, comorbidities, and durations of symptoms were comparable between time intervals.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>DAIR is a viable option in patients with early PJI presenting more than 4 weeks after index surgery, as long as DAIR is performed within at least 1 week after the onset of symptoms and modular components can be exchanged.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciz867","type":"journal-article","created":{"date-parts":[[2019,8,30]],"date-time":"2019-08-30T11:47:28Z","timestamp":1567165648000},"page":"630-636","source":"Crossref","is-referenced-by-count":56,"title":["Debridement, Antibiotics, and Implant Retention Is a Viable Treatment Option for Early Periprosthetic Joint Infection Presenting More Than 4 Weeks After Index Arthroplasty"],"prefix":"10.1093","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3532-537X","authenticated-orcid":false,"given":"Claudia A M","family":"L\u00f6wik","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javad","family":"Parvizi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rothman Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul C","family":"Jutte","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wierd P","family":"Zijlstra","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Medical Center Leeuwarden, Leeuwarden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bas A S","family":"Knobben","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Martini Hospital, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rothman Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karan","family":"Goswami","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rothman Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine A","family":"Belden","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Sydney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Sousa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Centro Hospitalar do Porto, Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Traumatology, University of Barcelona, Hospital Clinic of Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Carlos","family":"Mart\u00ednez-Pastor","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Traumatology, University of Barcelona, Hospital Clinic of Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Soriano","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, University of Barcelona, Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer, Hospital Clinic of Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjan","family":"Wouthuyzen-Bakker","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,8,31]]},"reference":[{"key":"2020072708270508900_CIT0001","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.semarthrit.2013.07.003","article-title":"Health economics in the field of osteoarthritis: an expert\u2019s consensus paper from the European 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