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Periprosthetic joint infection (PJI) is a devastating complication after total shoulder arthroplasty (TSA). Although staged revision arthroplasty is the standard treatment in many cases, surgical intervention with open debridement, antibiotics, and implant retention (DAIR) can be an effective alternative for acute PJI. Open DAIR resolves the infection in about 75% of cases. It is not advised to perform a second open DAIR if the first one fails. Changing the mobile parts of PJI during the open DAIR procedure almost doubles the likelihood of long-term remission. There are some factors that have a negative influence on the likelihood of a successful open DAIR procedure: fracture revision, utilization of cement, bacteremia, kidney and/or liver failure, immunosuppression, and elevated C-reactive protein.

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Open Debridement, Antibiotic, and Implant Retention (DAIR) for Periprosthetic Joint Infection in Total Shoulder Arthroplasty

  • 章节

  • 发表日期：

    2025年

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  • E. Carlos Rodríguez-Merchán,
  • Alfonso Vaquero-Picado

摘要

Periprosthetic joint infection (PJI) is a devastating complication after total shoulder arthroplasty (TSA). Although staged revision arthroplasty is the standard treatment in many cases, surgical intervention with open debridement, antibiotics, and implant retention (DAIR) can be an effective alternative for acute PJI. Open DAIR resolves the infection in about 75% of cases. It is not advised to perform a second open DAIR if the first one fails. Changing the mobile parts of PJI during the open DAIR procedure almost doubles the likelihood of long-term remission. There are some factors that have a negative influence on the likelihood of a successful open DAIR procedure: fracture revision, utilization of cement, bacteremia, kidney and/or liver failure, immunosuppression, and elevated C-reactive protein.