Irrigation and debridement in the management of prosthetic joint infection: traditional indications revisited.

Abstract	Irrigation and debridement (I and D) is a procedure commonly used for the treatment of acute periprosthetic infection. This study retrospectively reviewed clinical records of patients with periprosthetic infection of the hip or knee who underwent I and D with retention of their prostheses between 1997 and 2005 at a single institution. One hundred four patients (44 males and 60 females) were identified. Mean age at time of initial debridement was 65 years. Average follow-up was 5.7 years. Treatment failure was defined as the need for resection arthroplasty or recurrent microbiologically proven infection. According to these criteria, I and D was successful in 46 patients (44%). Patients with staphylococcal infection, elevated American Society of Anesthesiologists score, and purulence around the prosthesis were more likely to fail. The high failure rate of this procedure implies that it should be preferably limited to select healthy patients with low virulence organisms and equivocal intraoperative findings.
Authors	Khalid A Azzam, Mark Seeley, Elie Ghanem, Matthew S Austin, James J Purtill, Javad Parvizi
Journal	The Journal of arthroplasty (J Arthroplasty) Vol. 25 Issue 7 Pg. 1022-7 (Oct 2010) ISSN: 1532-8406 [Electronic] United States
PMID	20378306 (Publication Type: Journal Article)
Copyright	Copyright © 2010 Elsevier Inc. All rights reserved.
Chemical References	Anti-Bacterial Agents
Topics	Adolescent Adult Aged Aged, 80 and over Anti-Bacterial Agents (therapeutic use) Arthroplasty, Replacement, Hip Arthroplasty, Replacement, Knee Debridement (methods) Female Follow-Up Studies Hip Prosthesis (microbiology) Humans Knee Joint (microbiology, surgery) Knee Prosthesis (microbiology) Male Middle Aged Prosthesis-Related Infections (drug therapy, surgery) ROC Curve Reoperation Retrospective Studies Risk Factors Staphylococcus (isolation & purification) Therapeutic Irrigation (methods) Treatment Failure Treatment Outcome Young Adult

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