Evidence-Based Protocols for the Prevention and Treatment of Prosthetic Joint Infection in Total Hip Arthroplasty: A Systematic Review
Table 2.
Treatment Protocols for Prosthetic JointInfection (PJI)
|
| Protocol |
Indications |
Reported Outcomes |
|
|
| DAIR [4,6] |
Acute PJI (<4 weeks); stable implant; short symptom duration |
Higher failure in S. aureus (21%) vs. Streptococcus spp. (0%) |
|
| No-Spacer Protocol [2] |
Severe infection or joint destruction; reduces spacer complications |
33% failure rate; avoids spacer-related complications |
|
| Two-stage Revision [2,3,17,26] |
Resistant/multimicrobial infections; poor soft tissue quality |
High eradication (82-100%), but higher morbidity |
|
| DAPRI [7] |
Modified DAIR with biofilm-targeting techniques |
80% success rate; improved biofilm eradication |
|
| One-stage Revision [1,23] |
Known organism, stable patient, no sinus tract or sepsis |
Lower morbidity, shorter LOS, fewer complications |
|
| Muscle Flaps [30] |
Large soft tissue defects or failed revision; used in limb salvage |
97-100% success rate; provides durable coverage and infection control |
|
Legend: PJI = Prosthetic Joint Infection; THA = Total Hip Arthroplasty; DAIR = Debridement, Antibiotics, Irrigation, and Retention; DAPRI = Debridement, Antibiotic Pearls, and Retention of the Implant; LOS = Length of Stay.
|
|
