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Debridement, antimicrobial therapy, and implant retention (DAIR) as curative strategy for acute periprosthetic hip and knee infections: a position paper of the European Bone & Joint Infection Society (EBJIS)
Authors/contributors
- Sigmund, Irene K. (Author)
- Ferry, Tristan (Author)
- Sousa, Ricardo (Author)
- Soriano, Alex (Author)
- Metsemakers, Willem-Jan (Author)
- Clauss, Martin (Author)
- Trebse, Rihard (Author)
- Wouthuyzen-Bakker, Marjan (Author)
Abstract
It has been shown that the outcome of a DAIR (debridement, antimicrobial therapy, and implant retention) procedure depends on multiple factors (e.g. infection type, host factors, clinical presentation, condition of surrounding soft tissue, causing pathogen, surgical technique, antimicrobial therapy); therefore, adequate patient selection is key for DAIR success. In this position paper, we discuss the most relevant factors influencing the outcome and define indications, contraindications, and risk factors for a DAIR procedure based on the most robust and most recently published data. Furthermore, we discuss the surgical technique in combination with systemic antimicrobial therapy in patients undergoing a DAIR procedure. This position paper may help reduce reinfection rates as well as the physical, psychological, and economic burden associated with periprosthetic joint infection (PJI). We believe that a reasonable outcome can be achieved with careful patient selection, a dedicated multidisciplinary team, and an appropriate surgical technique and antimicrobial therapy.
Publication
Journal of Bone and Joint Infection
Date
2025-04-01
Citation
1.
Sigmund IK, Ferry T, Sousa R, et al. Debridement, antimicrobial therapy, and implant retention (DAIR) as curative strategy for acute periprosthetic hip and knee infections: a position paper of the European Bone & Joint Infection Society (EBJIS). J Bone Joint Infect. 2025;10(2):101-138.
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