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

ArticleinThe Journal of arthroplasty 28(3) · November 2012with12 Reads
Impact Factor: 2.67 · DOI: 10.1016/j.arth.2012.06.034 · Source: PubMed

    Abstract

    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.