Can This Joint Be Saved?

Infected prosthetic joints sometimes can be treated with surgical debridement alone, without removing and replacing hardware. However, many uncertainties persist about whether this strategy will be successful, especially when the culprit is Staphylococcus aureus.

Spanish investigators assembled the largest retrospective series to date of prosthetic joints infected with S. aureus and treated with “DAIR” (debridement, antibiotics, and implant retention). Most of the 345 cases involved hips (42%) or knees (57%), and 62% occurred within 1 month after joint-replacement surgery. Bacteremia and sinus tract infections were each identified in <20% of cases. Among S. aureus isolates, about 25% were methicillin resistant; 19% of infections were polymic…