title: Periprosthetic knee infections treated with irrigation and debridement: outcomes and preoperative predictive factors.
abstract: The role of irrigation and debridement (I&D) in the treatment of periprosthetic joint infections (PJI) of the knee remains controversial. Our purpose was to identify the success rate and factors determining outcome of I&D in those patients. Clinical characteristics of 78 patients with PJI of the knee treated with I&D were retrospectively reviewed. Implant retention at final follow-up was achieved in 43 patients (55.1%). Logistic regression analysis revealed that duration of symptoms >5days and thyroid disease were independent predictors of I&D failure. Patients with methicillin-resistant staphylococcal infections had a success rate of 45.5% and significantly lower odds of success compared to patients with negative cultures. In selected patients, I&D is a reasonable option in the context of acute PJI of the knee.
authors.affiliation: Department of Orthopaedic Surgery, Division of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York.
authors.forename: Georgios K
authors.initials: GK
authors.lastname: Triantafyllopoulos
authors.affiliation: Department of Orthopaedic Surgery, Division of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York.
authors.forename: Lazaros A
authors.initials: LA
authors.lastname: Poultsides
authors.affiliation: Department of Epidemiology and Biostatistics, The George Washington University.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Orthopaedic Surgery, Division of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York.
authors.forename: Peter K
authors.initials: PK
authors.lastname: Sculco
authors.affiliation: Department of Epidemiology and Biostatistics, The George Washington University.
authors.forename: Yan
authors.initials: Y
authors.lastname: Ma
authors.affiliation: Department of Orthopaedic Surgery, Division of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York.
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Sculco
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015992:Body Mass Index; D003646:Debridement; D005260:Female; D006801:Humans; D007719:Knee Joint; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D016459:Prosthesis-Related Infections / Q000188:drug therapy*; D012044:Regression Analysis; D012189:Retrospective Studies; D007507:Therapeutic Irrigation; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: debridement; irrigation; knee; outcomes; periprosthetic joint infections; predictive factors