Treatment of Prosthetic Joint Infections: Validation of a Surgical Algorithm and Proposal of a Simplified Alternative

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• 作者：Valé ; rie Martel-Laferriè ; re ; MD^a ; ; Pierre Laflamme ; MD^b ; Marc Ghannoum ; MD^c ; Julio Fernandes ; MD ; PhD ; MBA^d ; Daniela Di Iorio ; MD^e ; Valé ; ry Lavergne ; MD ; MSc^b
• 关键词：prosthetic joint infection ; surgical algorithm ; orthopedic infection ; debridement and implant retention ; gram-negative bacilli
• 刊名：The Journal of Arthroplasty
• 出版年：2013
• 出版时间：March, 2013
• 年：2013
• 卷：28
• 期：3
• 页码：395-400
• 全文大小：258 K

文摘

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.