Treatment of prosthetic joint infections: validation of a surgical algorithm and proposal of a simplified alternative.

The Del Pozo and Patel (DPP) algorithm permits to identify suitable candidates for debridement and implant retention (DR) in prosthetic joint infections (PJI), but does not include gram-negative bacilli (GNB) as a risk factor of worst outcome. We conducted a retrospective study to validate the DPP algorithm and propose a simplified algorithm including GNB PJI. From 2002 to 2009, 73 PJI underwent surgery; 55% were chosen according to PDD algorithm. Non-adherence increased the risk of treatment failure (HR = 4.2). Performing DR in the presence of GNB PJI and performing DR in a joint prosthesis implanted for >3 months without hematogenous infection were independent risk factors. Our simplified algorithm, based on these 2 criteria, showed comparable performance to the DPP algorithm but increased eligibility for DR by a 2.4 fold. Copyright © 2013 Elsevier Inc. All rights reserved.

Citation

Valérie Martel-Laferrière, Pierre Laflamme, Marc Ghannoum, Julio Fernandes, Daniela Di Iorio, Valéry Lavergne. Treatment of prosthetic joint infections: validation of a surgical algorithm and proposal of a simplified alternative. The Journal of arthroplasty. 2013 Mar;28(3):395-400

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PMID: 23151368

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