Time from admission to surgery may affect treatment success in patients with PJI after TKA
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Key takeaways:
- Time of more than 48 hours from admission to debridement, antibiotic and implant retention was associated with reoperation.
- Lower preoperative hemoglobin levels were associated with 90-day readmission.
Results presented here showed delays from admission to debridement, antibiotic and implant retention for periprosthetic joint infection after total knee arthroplasty may result in poor outcomes.
“Timing from admission to [debridement, antibiotic and implant retention] DAIR greater than 48 hours was associated with an almost ninefold increase in reoperation for PJI and almost 48-fold increased risk for postoperative complications,” Simon Garceau, MD, assistant professor in the department of surgery at the University of Ottawa, said in his presentation at the Musculoskeletal Infection Society Annual Meeting.
Garceau and colleagues retrospectively analyzed data from 121 patients who underwent a DAIR procedure for the treatment of PJI after TKA. Outcomes included reoperation, 90-day readmission and mortality rates.
Garceau said timing from admission to DAIR of more than 48 hours was associated with reoperation for PJI and postoperative complications. In addition, he said lower preoperative hemoglobin levels were also associated with 90-day readmission.
According to Garceau, almost 50% of patients who had a delay of more than 48 hours from admission to a DAIR procedure did not have a clear reason for their delay.
“Timing from admission to DAIR has a significant effect on reoperation for recalcitrant PJI and complication risk,” Garceau said. “Surgeons should advocate for rapid OR access within 48 hours from admission when performing DAIR in the treatment of total knee arthroplasty PJI.”
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Garceau S, et al. Paper 1359. Presented at: Musculoskeletal Infection Society Annual Meeting; Aug. 2-3, 2024; Durham, North Carolina (hybrid meeting).
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