Work

Association between body mass index and failure after DAIR or DAPRI for acute hematogenous knee periprosthetic joint infection

Year: 2026

Type: article

Abstract: Debridement, antibiotics, and implant retention (DAIR) and debridement plus antibiotic-loaded devices (DAPRI) are commonly used for acute hematogenous knee periprosthetic joint infection (PJI), yet a substantial proportion of patients require further surgery. Exploring factors associated with failure may improve our understanding of treatment outcomes and support the design of future studies. We performed a retrospective analysis of consecutive patients with acute hematogenous knee PJI treated with DAIR or DAPRI. Failure was defined as the need for any additional surgical procedure within 12 months from the index intervention. Patients were compared according to treatment outcome using univariate tests appropriate for data distribution and cell counts. Given the limited sample size and the small number of failure events, no multivariable analysis or data-derived threshold analysis was performed. The findings were considered exploratory and hypothesis-generating. Thirty-five patients were included; 11 (31.4%) failed within 12 months. Patients who experienced treatment failure had a higher BMI than those with treatment success (33.7 ± 6.2 vs. 27.6 ± 2.8 kg/m²; p = 0.018). They also showed lower preoperative hemoglobin, albumin, and PNI values. These findings represent unadjusted exploratory associations. In this cohort of acute hematogenous PJI treated with DAIR/DAPRI, higher BMI and lower preoperative hemoglobin, albumin, and PNI were associated with treatment failure. These findings should be interpreted cautiously and require confirmation in larger prospective studies. Not applicable.

Source: BMC Musculoskeletal Disorders

DOI: 10.1186/s12891-026-10610-9