ICJR Interviews: An Aggressive Debridement Protocol for Acute PJI

    In a periprosthetic hip or knee infection, debridement with prosthesis retention is generally not a great treatment option, with reported failure rates of 60% to 70%.

    Surgeons at Mayo Clinic in Phoenix, Arizona, however, are having much better success with an aggressive 2-stage debridement and prosthesis retention protocol for acute periprosthetic joint infections. Their protocol includes the use of high-dose antibiotic beads in the first debridement, intravenous antibiotics after the second procedure, and long-term antibiotic use for certain patients.

    In their first study on this protocol, they reported a success rate of 90%, with follow-up averaging 3.5 years.

    Their second, larger study – presented at the 2016 Annual Meeting of the American Academy of Orthopaedic Surgeons in Orlando – reported similar success with average follow-up of 44 months.

    Henry D. Clarke, MD, discusses the methodology and results of the study, “Two-Stage Debridement with Prosthesis Retention for Acute Infections Following Primary Hip or Knee Arthroplasty “ (Paper 240).

    Click the image above to hear his comments.

    Producer: Susan Doan-Johnson; Director and Post Production: Charles J. Maynard