Can debridement, antibiotics and implant retention (DAIR) be utilized in the treatment of acute periprosthetic joint infection (PJI) with a megaprosthesis?

Authors: Dwikora Novembri Utomo, Nicolaas Budhiparama, Andrew Battenberg, Ferdiansyah Mahyudin, KuKuh Dwiputra Hernugrahanto, I. Lumban-Gaol
RECOMMENDATION: DAIR is a viable treatment option in acute PJI of a megaprosthesis. The eff ectiveness of DAIR is still unclear due to lack of comparative data among the treatment options and limited evidence to suggest superiority of any one treatment. The treatment decision must be made on a case-by-case basis and account for underlying medical conditions, infection history, organism characteristics and surgical history. DAIR
is most appropriate for acute PJI without complicating factors, such as extensive and pervasive infection by a high virulence or resistant organism.
LEVEL OF EVIDENCE: Limited
DELEGATE VOTE: Agree: 96%, Disagree: 1%, Abstain: 3% (Unanimous, Strongest Consensus)

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