title: Multiple Irrigation and Debridements for Periprosthetic Joint Infections: Facing a Necessity or Just Prolonging the Inevitable?
abstract: Irrigation and debridement (I&D) may be a viable option in selected cases of periprosthetic joint infections (PJI). Our aim was to investigate the role of multiple I&Ds. Among 141 patients with PJI treated with I&D in our institution, 19 were subjected to additional procedures. Their clinical characteristics were retrospectively reviewed and compared to the remaining patients treated with a single I&D. The probability of treatment failure (removal of implants) was not significantly different among the two groups. The interval between serial I&Ds was a significant factor determining outcomes. Patients treated with multiple I&Ds had a significantly higher prevalence of peripheral vascular disease. The decision to proceed with repeat of I&D should be made with caution.
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
authors.initials: G
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: Epidemiology and Biostatistics Core, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York.
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: Epidemiology and Biostatistics Core, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York.
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; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D003646:Debridement; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016459:Prosthesis-Related Infections / Q000601:surgery*; D012189:Retrospective Studies; D007507:Therapeutic Irrigation; D017211:Treatment Failure; D016896:Treatment Outcome
keywords: hip; knee; multiple irrigation and debridements; outcomes; periprosthetic joint infections