Journal article
The use of antibiotic-loaded calcium sulphate beads in debridement, antibiotics, and implant retention (DAIR) for periprosthetic infections: a retrospective comparative cohort on outcome
- Abstract:
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Background and purpose: We aimed to compare the effect of calcium sulphate (CS) beads loaded with antibiotics on infection eradication in debridement, antibiotics, and implant retention (DAIR) of periprosthetic joint infection relative to DAIR without local antibiotics delivery.Methods: 176 patients with hip or knee arthroplasty undergoing DAIR were retrospectively identified and divided into a bead group (n = 102) and a control group (n = 74). Infections were classified as early postoperative, acute hematogenous, and chronic. Logistic regression analyses were performed on the use of CS beads. Revision-free and infection-free survival was estimated using Kaplan–Meier analysis.Results: Reinfection occurred in 36% of the bead group, and 39% of the control group (odds ratio [OR] 0.9, 95% confidence interval [CI] 0.5– 1.6); reoperation rates were 34% and 43% (OR 0.7, CI 0.4–1.3). Kaplan–Meier analysis showed no statistically significant difference between the 2 groups regarding infection-free (HR 1.1, CI 0.7–1.8) and revision-free (HR 1.1, CI 0.7–1.9) survival rates. In acute hematogenous PJIs, reinfection (29% vs 56%, OR 0.3, CI 0.1–1.1) and reoperation rates (25% vs 61%, OR 0.2, CI 0.1–0.8) were reduced when CS beads were used; Kaplan–Meier analysis revealed higher infection-free (HR 0.5, CI 0.2–1.4) and revision-free (HR 0.5, CI 0.2–1.3) survival rates in the bead group but not of statistical significance. Wound drainage was not increased by CS beads use (OR 1.0, CI 0.99–1.01), but hypercalcemia was seen in 9% in the bead group.Conclusion: DAIR with antibiotic-loaded CS beads did not improve outcome in early postoperative and chronic PJIs, but reduced the reoperation rate in acute haematogenous infections with similar results compared with early postoperative PJIs.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 896.9KB, Terms of use)
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- Publisher copy:
- 10.2340/17453674.2024.42360
Authors
- Publisher:
- Medical Journals Sweden
- Journal:
- Acta Orthopaedica More from this journal
- Volume:
- 95
- Pages:
- 707-714
- Place of publication:
- Sweden
- Publication date:
- 2024-11-29
- DOI:
- EISSN:
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1745-3682
- ISSN:
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1745-3674
- Pmid:
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39611436
- Language:
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English
- Keywords:
- Pubs id:
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2067730
- Local pid:
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pubs:2067730
- Deposit date:
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2025-01-17
- ARK identifier:
Terms of use
- Copyright holder:
- Sigmund et al
- Copyright date:
- 2024
- Rights statement:
- © 2024 The Author(s). Published by MJS Publishing – Medical Journals Sweden, on behalf of the Nordic Orthopedic Federation. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/), which permits sharing, adapting, and using the material for any purpose, including commercial use, with the condition of providing full attribution to the original publication.
- Licence:
- CC Attribution (CC BY)
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