The Journal of Arthroplasty
Volume 26, Issue 6, Supplement , Pages 114-118, September 2011

Irrigation and Debridement for Periprosthetic Infections:

Does the Organism Matter?

  • Susan M. Odum, MEd

      Affiliations

    • OrthoCarolina Research Institute, Inc, Charlotte, North Carolina
    • Corresponding Author InformationReprint requests: Susan M. Odum, MEd, OrthoCarolina Research Institute, Inc, 2001 Vail Avenue, Suite 300, Charlotte, NC 28207.
    • ,
  • Thomas K. Fehring, MD

      Affiliations

    • OrthoCarolina, Charlotte, North Carolina
    • ,
  • Adolph V. Lombardi, MD

      Affiliations

    • Joint Implant Surgeons, Inc, New Albany, Ohio
    • ,
  • Ben M. Zmistowski, BS

      Affiliations

    • Rothman Institute, Philadelphia, Pennsylvania
    • ,
  • Nicholas M. Brown, BS

      Affiliations

    • Rush Medical Center, Chicago, Illinois
    • ,
  • Jeffrey T. Luna, MD

      Affiliations

    • VA Medical Center, Minneapolis, Minnesota
    • ,
  • Keith A. Fehring, MD

      Affiliations

    • Medical College of Virginia, Richmond, Virginia
    • Keith R. Berend, MD, Kevin J. Bozic, MD, Craig J. Della Valle, MD, Terence J. Gioe, MD, William A. Jiranek, MD, Javad Parvizi, MD, and Bryan D. Springer, MD.
    • ,
  • Erik N. Hansen, MD

      Affiliations

    • University of California at San Francisco, San Francisco, California
    • Keith R. Berend, MD, Kevin J. Bozic, MD, Craig J. Della Valle, MD, Terence J. Gioe, MD, William A. Jiranek, MD, Javad Parvizi, MD, and Bryan D. Springer, MD.
    • ,
  • The Periprosthetic Infection Consortium

      Affiliations

    • Keith R. Berend, MD, Kevin J. Bozic, MD, Craig J. Della Valle, MD, Terence J. Gioe, MD, William A. Jiranek, MD, Javad Parvizi, MD, and Bryan D. Springer, MD.

Received 12 July 2010; accepted 15 March 2011. published online 30 May 2011.

Abstract 

Irrigation and debridement (I&D) is an attractive treatment alternative for periprosthetic joint infection (PJI). Irrigation and debridement failure rates average 64% (range, 10.5%-84%) and may be associated with causative organism type and virulence. The study objective was to compare revision rates for PJI caused by streptococcal organisms to other organisms treated with I&D. A multicenter retrospective cohort study of 200 consecutive PJIs treated with I&D was performed. Failure was defined as reoperation for PJI. Failure rate for streptococcal infections was 65% (20/31) compared with 71% (84/119) for other organisms. Failure rate for sensitive Staphylococcus was 72% (48/67) compared with a 76% (22/29) failure rate for resistant Staphylococcus. These results indicate that eradication rates of I&D for a streptococcal PJI are comparable with other causative organisms. Irrigation and debridement should play a limited role in the PJI treatment algorithm regardless of organism type.

Keywords: periprosthetic joint infection, revision arthroplasty, causative organism

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 The Conflict of Interest statement associated with this article can be found at doi:10.1016/j.arth.2011.03.031.

PII: S0883-5403(11)00135-5

doi:10.1016/j.arth.2011.03.031

The Journal of Arthroplasty
Volume 26, Issue 6, Supplement , Pages 114-118, September 2011

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