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World J Orthop. Nov 18, 2014; 5(5): 667-676
Published online Nov 18, 2014. doi: 10.5312/wjo.v5.i5.667
Treatment of acute periprosthetic infections with prosthesis retention: Review of current concepts
Jesse WP Kuiper, Robin Tjeenk Willink, Dirk Jan F Moojen, Michel PJ van den Bekerom, Sascha Colen
Jesse WP Kuiper, Center for Orthopaedic Research Alkmaar, Medical Center Alkmaar, 1815 JD, Alkmaar, The Netherlands
Jesse WP Kuiper, Department of Surgery, Spaarne Hospital, 2134 TM, Hoofddorp, The Netherlands
Robin Tjeenk Willink, Sascha Colen, Department of Orthopaedic Surgery, University Hospitals Leuven, 3212 Leuven, Belgium
Dirk Jan F Moojen, Michel PJ van den Bekerom, Department of Orthopaedic Surgery and Traumatology, Onze Lieve Vrouwe Gasthuis, 1091 AC, Amsterdam, The Netherlands
Sascha Colen, Department of Orthopedic Surgery and Traumatology, Sint Bonifatius Hospital, 49808 Lingen, Germany
Author contributions: Kuiper JWP, van den Bekerom MPJ and Colen S designed the study; all authors performed research, wrote the manuscript and revised the manuscript
Correspondence to: Jesse WP Kuiper, MD, Center for Orthopaedic Research Alkmaar, Medical Center Alkmaar, Wilhelminalaan 12, 1815 JD, Alkmaar, The Netherlands.
Telephone: +31-72-5482503 Fax: +31-72-5482168
Received: January 6, 2014
Revised: April 28, 2014
Accepted: May 31, 2014
Published online: November 18, 2014
Core Tip

Core tip: Acute periprosthetic joint infection (PJI) is a major complication after total joint arthroplasty, and occurs either postoperatively or via hematogenous spreading. Debridement, antibiotics and implant retention (DAIR), the primary treatment for acute PJI, should be performed as soon as possible after the development of symptoms, and has success rates around 60%-80%. Whether single or multiple debridement procedures are more successful remains unclear. Systemic treatment, based on culture results, is important for all PJI treatments. Various factors for treatment failure can be identified. For acute PJI, DAIR has good success rates, especially in selected patients.