Open debridement and prosthesis retention is a viable treatment option for acute periprosthetic joint infection after total knee arthroplasty

Abstract

Open debridement with prosthesis retention (ODPR) has been considered as a reasonable treatment option for acute periprosthetic joint infection (PJI) following total knee arthroplasty (TKA). However, multiple recent studies have challenged this contention. This study was undertaken to determine the success rate of ODPR, whether the success rate was affected by the ODPR timing or by the microorganisms. We retrospectively reviewed 52 cases of ODPR performed in four institutions to treat acute PJI which met the definition of PJI by the International Consensus Group on PJI. We recorded patient demographics; time from index TKA and symptom duration; the microorganisms involved; and whether the infection was controlled or not. The overall success rate of ODPR was 71 %, and early postoperative infection and acute hematogenous infection had a success rate of 82 and 55 %, respectively. Success rate was associated with a shorter symptom duration in patients with acute hematogenous infections (p = 0.040). However, success was not influenced by the type (p = 0.992) or virulence of the causative microorganisms (p = 0.706). ODPR should be considered as a viable treatment option for acute PJI following TKA. The promptness of ODPR is of paramount importance for success of ODPR, rather than the causative organism type or virulence.