Journal of Bone and Joint Infection
Journal of Bone and Joint Infection
JBJI
Articles | Volume 10, issue 2
Articles | Volume 10, issue 2
https://doi.org/10.5194/jbji-10-73-2025
© Author(s) 2025. This work is distributed under
the Creative Commons Attribution 4.0 License.
https://doi.org/10.5194/jbji-10-73-2025
© Author(s) 2025. This work is distributed under
the Creative Commons Attribution 4.0 License.
Articles | Volume 10, issue 2
Original full-length article
 | 
24 Mar 2025
Original full-length article |  | 24 Mar 2025

Comparison of surgical treatments for hip and knee periprosthetic joint infections using the desirability of outcome ranking in a prospective multicentre study

Brenton P. Johns, Mark R. Loewenthal, David C. Dewar, Laurens A. Manning, and Joshua S. Davis

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A desirability of outcome ranking (DOOR) for periprosthetic joint infection – a Delphi analysis
Brenton P. Johns, David C. Dewar, Mark R. Loewenthal, Laurens A. Manning, Amit Atrey, Nipun Atri, David G. Campbell, Michael Dunbar, Christopher Kandel, Amir Khoshbin, Christopher W. Jones, Jaime Lora-Tamayo, Catherine McDougall, Dirk Jan F. Moojen, Jonathan Mulford, David L. Paterson, Trisha Peel, Michael Solomon, Simon W. Young, and Joshua S. Davis
J. Bone Joint Infect., 7, 221–229, https://doi.org/10.5194/jbji-7-221-2022,https://doi.org/10.5194/jbji-7-221-2022, 2022
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Subject: Prosthesis-related infections | Topic: Surgery
Mid-term to long-term outcome and risk factors for failure of 158 hips with two-stage revision for periprosthetic hip joint infection
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Do one-stage indications predict success following two-stage arthroplasty for chronic periprosthetic joint infection?
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Outcomes of the gastrocnemius flap performed by orthopaedic surgeons in salvage revision knee arthroplasty
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Long-term outcome of two-stage revision surgery after hip and knee prosthetic joint infections: an observational study
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Timing of debridement, antibiotics, and implant retention (DAIR) for early post-surgical hip and knee prosthetic joint infection (PJI) does not affect 1-year re-revision rates: data from the Dutch Arthroplasty Register
Barry van der Ende, Jakob van Oldenrijk, Max Reijman, Peter D. Croughs, Liza N. van Steenbergen, Jan A. N. Verhaar, and P. Koen Bos
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Cited articles

Boyle, K. K., Kapadia, M., Landy, D. C., Henry, M. W., Miller, A. O., and Westrich, G. H.: Utilization of Debridement, Antibiotics, and Implant Retention for Infection After Total Joint Arthroplasty Over a Decade in the United States, J. Arthroplasty, 35, 2210–2216, https://doi.org/10.1016/j.arth.2020.03.029, 2020. 
Bryan, A. J., Abdel, M. P., Sanders, T. L., Fitzgerald, S. F., Hanssen, A. D., and Berry, D. J.: Irrigation and Debridement with Component Retention for Acute Infection After Hip Arthroplasty: Improved Results with Contemporary Management, J. Bone Joint Surg. Am., 99, 2011–2018, https://doi.org/10.2106/jbjs.16.01103, 2017. 
Carroll, F. E., Gooberman-Hill, R., Strange, S., Blom, A. W., and Moore, A. J.: What are patients' preferences for revision surgery after periprosthetic joint infection? A discrete choice experiment, BMJ Open, 10, e031645, https://doi.org/10.1136/bmjopen-2019-031645, 2020. 
Charalambous, L. T., Kim, B. I., Schwartz, A. M., Case, A., Seidelman, J. L., Hendershot, E. F., Bolognesi, M. P., Seyler, T. M., and Jiranek, W. A.: Prosthetic Knee Infection With Coagulase-Negative Staphylococcus: A Harbinger of Poor Outcomes, J. Arthroplasty, 37, S313–S320, https://doi.org/10.1016/j.arth.2022.02.050, 2022. 
Choi, H. R., von Knoch, F., Zurakowski, D., Nelson, S. B., and Malchau, H.: Can implant retention be recommended for treatment of infected TKA?, Clin. Orthop. Relat. R., 469, 961–969, https://doi.org/10.1007/s11999-010-1679-8, 2011. 
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The desirability of outcome ranking (DOOR) combines joint function, infection cure and mortality into one outcome. Using the DOOR, we describe patient outcomes after prosthetic joint infection (PJI) treatment; moreover, debridement, antibiotics and implant retention (DAIR) is compared with two-stage exchange. Infections were classified as early (≤ 90 d post-arthroplasty) or late (> 90 d post-arthroplasty). For early PJI, DAIR was superior to two-stage exchange, whereas two-stage revision was superior to DAIR for late PJI.
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