Actualización del tratamiento de infecciones agudas en prótesis de rodilla: ¿es posible retener los componentes? Una mirada en profundidad al procedimiento DAIR

Abstract

Introduction

Periprosthetic knee infections are serious complications after knee arthroplasty, affecting 1 to 2% of patients with primary surgery and up to 20% of revisions. The DAIR strategy (debridement, antibiotics, and implant retention) has emerged as a treatment for acute infections, allowing component retention in certain cases, with a high success rate.

Objectives

This review discusses its application, success factors, techniques such as the «double DAIR» and postoperative management, highlighting the importance of correct patient selection and the combination of a thorough and meticulous surgical technique with appropriate antibiotic therapy to optimize results.

Methods

An exhaustive updated literature search was conducted regarding the use of DAIR in acute periprosthetic infections, highlighting the step-by-step procedure and some surgical tips that are helpful when performing it. Based on this, recommendations were made for physicians interested in the subject.

Results

A series of recommendations are made based on current literature, which are a useful guide when dealing with patients with acute infections in the context of knee prostheses, with a success rate greater than 70% in most cases where the patient is well selected.

Conclusions

DAIR is a useful and effective tool in the eradication and treatment of acute periprosthetic infections, with a good success rate. It is a cheap, technically simple and reproducible procedure, so as a group, we suggest it be adopted globally by orthopedic surgeons.