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Introduction

Treatment of prosthetic joint infection (PJI) following total knee arthroplasty (TKA) may guided by PJI classification, taking into account infection duration and potential for biofilm formation. Debridement, antibiotics and implant retention (DAIR) is recommended for ‘post-operative’ and ‘acute’ haematogenous PJI. However, the time cut-off for ‘post-operative’ PJI varies across classification systems. Furthermore, poor DAIR success rates have been reported in acute haematogenous PJIs. This study aimed to determine the success of DAIR in a large cohort of PJIs, and assess the utility of current classification systems for predicting DAIR outcomes.

Method

In this multicentre retrospective, cohort study, we identified 230 patients undergoing DAIR for first episode PJI following primary TKA. Patient demographics, disease and surgical factors were identified, and PJI subtype, post-operative antibiotic regime and treatment outcomes were recorded. Statistical analysis was performed to identify factors associated with failed DAIR, and success rates were analysed by multiple classification systems using receiver operating characteristic (ROC) curves.