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Irrigation and Debridement with Component Retention

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Abstract

A periprosthetic joint infection is a devastating complication after total joint arthroplasty. While patients with a chronic infection are treated with one-stage or two-stage revision, some patients with an acute infection may be treated with irrigation and debridement with component retention. The purpose of this chapter is describe the indications, contraindications, surgical technique and published results on irrigation and debridement with polyethylene liner exchange and component retention.

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References

  1. Hoover NW, Ivins JC. Wound debridement. A M A Arch Surg. 1959;79(5):701–10. doi:10.1001/archsurg.1959.04320110003001.

    Article  CAS  Google Scholar 

  2. Huntley JS. Debridement: development of the concept. J Perioper Pract. 2011;21(3):104–5.

    PubMed  Google Scholar 

  3. Shuman EK, Urquhart A, Malani PN. Management and prevention of prosthetic joint infection. Infect Dis Clin North Am. 2012;26(1):29–39.

    Article  PubMed  Google Scholar 

  4. Triantafyllopoulos GK, Poultsides LA, Sakellariou VI, Zhang W, Sculco PK, Ma Y, et al. Irrigation and debridement for periprosthetic infections of the hip and factors determining outcome. Int Orthop. 2015;39(6):1203–9.

    Article  PubMed  Google Scholar 

  5. Sherrell JC, Fehring TK, Odum S, Hansen E, Zmistowski B, Dennos A, Kalore N. The Chitranjan Ranawat Award: fate of two-stage reimplantation after failed irrigation and debridement for periprosthetic knee infection. Clin Orthop Relat Res. 2011;469:18–25.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Lora-tamayo J, Murillo O, Iribarren JA, Soriano A, Sánchez-Somolinos M, Baraia-Etxaburu JM, et al. A large multicenter study of methicillin-susceptible and methicillin-resistant Staphylococcus aureus prosthetic joint infections managed with implant retention. Clin Infect Dis. 2013;56(2):182–94.

    Article  PubMed  Google Scholar 

  7. Zimmerli W, Trampuz A, Ochsner PE. Prosthetic-joint infections. N Engl J Med. 2004;351(16):1645–54.

    Article  CAS  PubMed  Google Scholar 

  8. Widmer AF. New developments in diagnosis and treatment of infection in orthopedic implants. Clin Infect Dis. 2001;33 Suppl 2:S94–106.

    Article  PubMed  Google Scholar 

  9. Anagnostakos K, Schmid NV, Kelm J, Grün U, Jung J. Classification of hip joint infections. Int J Med Sci. 2009;6(5):227–33.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Odum SM, Fehring TK, Lombardi AV, Zmistowski BM, Brown NM, Luna JT, et al. Irrigation and debridement for periprosthetic infections: does the organism matter? J Arthroplasty. 2011;26(6 Suppl):114–8.

    Article  PubMed  Google Scholar 

  11. Brandt CM, Sistrunk WW, Duffy MC, Hanssen AD, Steckelberg JM, Ilstrup DM, et al. Staphylococcus aureus prosthetic joint infection treated with debridement and prosthesis retention. Clin Infect Dis. 1997;24(5):914–9.

    Article  CAS  PubMed  Google Scholar 

  12. Anagnostakos K, Schmitt C. Can periprosthetic hip joint infections be successfully managed by debridement and prosthesis retention? World J Orthop. 2014;5(3):218–24.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Parvizi J, Gehrke T, Chen AF. Proceedings of the International Consensus on periprosthetic joint infection. Bone Joint J. 2013;95-B(11):1450–2.

    Article  CAS  PubMed  Google Scholar 

  14. Namba RS, Paxton L, Fithian DC, Stone ML. Obesity and perioperative morbidity in total hip and total knee arthroplasty patients. J Arthroplasty. 2005;20:46–50.

    Article  PubMed  Google Scholar 

  15. Barberán J, Aguilar L, Carroquino G, Giménez MJ, Sánchez B, Martínez D, et al. Conservative treatment of staphylococcal prosthetic joint infections in elderly patients. Am J Med. 2006;119(11):993.e7–10.

    Article  Google Scholar 

  16. Buller LT, Sabry FY, Easton RQ, Klika AK, Barsoum WK. The preoperative prediction of success following irrigation and debridement with polyethylene exchange for hip and knee prosthetic joint infections. J Arthroplasty. 2012;27:857-64.el–4.

    Article  Google Scholar 

  17. Schoof B, Jakobs O, Schmidl S, Klatte TO, Frommelt L, Gehrke T, et al. Fungal periprosthetic joint infection of the hip: a systematic review. Orthop Rev (Pavia). 2015;7(1):5748.

    Article  Google Scholar 

  18. Jakobs O, Schoof B, Klatte TO, Schmidl S, Fensky F, Guenther D, et al. Fungal periprosthetic joint infection in total knee arthroplasty: a systemic review. Orthop Rev (Pavia). 2015;7(1):5623.

    Article  Google Scholar 

  19. Triantafyllopoulos G, Poultsides LA, Zhang W, Sculco PK, Ma Y, Sculco TP. Multiple irrigation and debridements for periprosthetic joint infections: facing a necessity or just prolonging the inevitable? J Arthroplasty. 2015. doi:10.1016/j.arth.2015.06.051.

    Google Scholar 

  20. Tetreault MW, Wetters NG, Aggarwal V, Mont M, Parvizi J, Della valle CJ. The Chitranjan Ranawat Award: should prophylactic antibiotics be withheld before revision surgery to obtain appropriate cultures? Clin Orthop Relat Res. 2014;472(1):52–6.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Archer NK, Mazaitis MJ, Costerton JW, Leid JG, Powers ME, Shirtliff ME. Staphylococcus aureus biofilms: properties, regulation, and roles in human disease. Virulence. 2011;2(5):445–59.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Fey PD, Olson ME. Current concepts in biofilm formation of Staphylococcus epidermidis. Future Microbiol. 2010;5(6):917–33.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Whiteside LA, Nayfeh TA, LaZear R, Roy ME. Reinfected revised TKA resolves with an aggressive protocol and antibiotic infusion. Clin Orthop Relat Res. 2012;470(1):236–43.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Osmon DR, Berbari EF, Berendt AR, Lew D, Zimmerli W, Steckelberg JM, et al. Diagnosis and management of prosthetic joint infection: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis. 2013;56(1):e1–25.

    Article  PubMed  Google Scholar 

  25. Kalghatgi S, Spina CS, Costello JC, Liesa M, Morones-Ramirez JR, Slomovic S, et al. Bactericidal antibiotics induce mitochondrial dysfunction and oxidative damage in Mammalian cells. Sci Transl Med. 2013;5(192):192ra85.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Kim JG, Bae JH, Lee SY, Cho WT, Lim HC. The parameters affecting the success of irrigation and debridement with component retention in the treatment of acutely infected total knee arthroplasty. Clin Orthop Surg. 2015;7(1):69–76.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Azzam KA, Seeley M, Ghanem E, Austin MS, Purtill JJ, Parvizi J. Irrigation and debridement in the management of prosthetic joint infection: traditional indications revisited. J Arthroplasty. 2010;25:1022–7.

    Article  PubMed  Google Scholar 

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Correspondence to Michael B. Cross MD .

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© 2016 Springer International Publishing Switzerland

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Trivellas, M., Cross, M.B. (2016). Irrigation and Debridement with Component Retention. In: Kendoff, D., Morgan-Jones, R., Haddad, F. (eds) Periprosthetic Joint Infections. Springer, Cham. https://doi.org/10.1007/978-3-319-30091-7_19

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  • DOI: https://doi.org/10.1007/978-3-319-30091-7_19

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-30089-4

  • Online ISBN: 978-3-319-30091-7

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