DAIR procedure in PJI:predictive tools of failure
(2019) 38th Annual Meeting of the European Bone and Joint Infection Society (EBJIS) — Location: (Belgium) Antwerp (12.September.2019)
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- (en) BACKGROUND: DAIR is an attractive treatment for PJI. The purpose of this study is to determine predictive factors of failure. MATERIALS AND METHODS: We reviewed all DAIR procedures for hip PJI performed between 2002- 2017 (n=69). Data recorded included all factors correlated with treatment failure. KLIC score and an adapted McPherson score (sum of three criteria where the lower score is three for 3 A and the higher is 9 for 3 C) were analyzed. RESULTS: Infection eradication for early PJI (< 4 weeks) was achieved in 68% of patients and was correlated with treatment success (p=0.01). Success rate was only 37.5% in hematogenous infection and 28% in late infection. KLIC score (p=0.036), McPherson adapted score (threshold value 5.5/9) (p=0.01), CRP (with a cut-off value at 73.5 mg%) (p=0.025) and late PJI (p=0.031) were significantly predictive of failure treatment. For the KLIC score, patients with a score of ≤2, >2-3.5, >4-6.5, ≥7, respectively obtained a rate of failure of 33.3%,60%,71% and 100%. We have established an equation in order to predict failure treatment. This tool predicts treatment failure when Logit P (equation result) is >0.476 with a sensitivity of 80% and a specificity of 83% (p = 0.05). CONCLUSIONS: KLIC and adapted McPherson scores predict outcome of DAIR and should help making the decision in PJI treatment. Tsang et al, demonstrates that symptoms lasting for less than 7 days represent a significant threshold. Despite 80% of our patients operated within 7 days, the analysis wasn’t significant. It seems that a DAIR procedure done promptly is not the only condition required for success and some others factors influence the outcome of treatment.
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Morcillo, D., Pastor y Geels, I., Detrembleur, C., Poilvache, H., Van Cauter, M., Yombi, J. C., & Cornu, O. (2019). DAIR procedure in PJI:predictive tools of failure. 38th Annual Meeting of the European Bone and Joint Infection Society (EBJIS), (Belgium) Antwerp. https://hdl.handle.net/2078.5/271927