Treatment of Acute Periprosthetic Joint Infection Comparing Single and Planned Double-Debridement Antibiotics and Implant Retention Followed by Chronic Antibiotic Suppression
Periprosthetic Joint Infection
About this trial
This is an interventional treatment trial for Periprosthetic Joint Infection focused on measuring Total knee arthroplasty, Total hip arthroplasty
Eligibility Criteria
Inclusion Criteria: Patients who speak English and are willing to sign the consent form Patients with acute early postoperative infection (symptoms ≤ 4 weeks from surgery; symptoms < 4 weeks in duration) and acute hematogenous infection (greater than 4 weeks from surgery; symptoms < 3 weeks in duration) of a primary total knee or total hip arthroplasty, defined as: A sinus communicating with the prosthesis OR Two positive cultures obtained from the prosthesis OR 4 of 5 criteria: Elevated ESR (> 30mm/hr) and CRP (> 10mg/L); Elevated synovial leukocyte count (>3000 cells/μL) or change of ++ on; leukocyte esterase strip; Elevated synovial neutrophil percentage (> 80%); One positive culture; Positive histological analysis of periprosthetic tissue (> 5 neutrophils per high; Power field in 5 high power fields x 400). OR Patient with an acute infection diagnosed clinically by an orthopedic surgeon treated with DAIR Exclusion Criteria: Patients with a chronic PJI, defined as: presentation of symptoms > 4 weeks in duration. Revision surgery or previous two-stage reimplantation.
Sites / Locations
- Mayo Clinic Florida
- Mayo Clinic Minnesota
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
Single DAIR Surgery Arm
Double DAIR Surgery Arm
Subjects will undergo a single Debridement Antibiotics and Implant Retention (DAIR) surgical procedure, along with IV antibiotics and followed by oral suppressive antibiotics. This method is currently used and considered to be standard of care.
Subjects will undergo planned double Debridement Antibiotics and Implant Retention (DAIR) surgical procedure, along with IV antibiotics and followed by oral suppressive antibiotics. This method is currently used and considered to be standard of care.