背景：单室膝关节置换术（UKR）后假体周围感染（PJI）并不常见，然而严重，并发症。在这种情况下，缺乏关于清创抗生素和植入物保留（DAIR）有效性的证据。本研究的目的是探讨DAIR治疗急性UKRPJI的有效性。
方法：在2006年至2019年之间，我们机构进行了5195UKR。在此期间,16例患者早期接受了DAIR，急性PJI.所有患者均符合MSISPJI诊断标准。DAIR的中位年龄为67岁（范围40-73），12例患者为男性（75.0％）。DAIR的中位时间为24天（范围6-60天）。在DAIR之后，对患者进行了中位6.5年（范围1.4-10.5）的随访。
结果：我们机构中0.3％（16/5195）的UKR在3个月内获得了DAIR。16例患者中有15例（93.8%）为培养阳性，与最常见的生物体MSSA（n=8，50.0%）。患者接受了生物体特异性静脉内抗生素治疗，中位时间为6周。随后口服抗生素，中位持续时间为6个月。PJI修订的Kaplan-Meier幸存者估计为57％（95CI：28-78％），所有原因修正的幸存者估计为52%（95CI：25-74%）。最终随访时，使用可行植入物的患者的牛津膝关节评分中位数为45分（范围39-46）。
结论：早期，UKR后急性PJI很少见。DAIR的成功率适中,5年无感染生存率为57%。那些用DAIR成功治疗的患者具有出色的功能结果和植入物存活。
BACKGROUND: Periprosthetic joint infection (PJI) following unicompartmental knee replacement (UKR) is an uncommon, yet serious, complication. There is a paucity of evidence regarding the effectiveness of Debridement-Antibiotics-and-Implant-Retention (DAIR) in this setting. The aim of this study is to investigate the effectiveness of DAIR for acute UKR PJI.
METHODS: Between 2006 and 2019, 5195 UKR were performed at our institution. Over this period, sixteen patients underwent DAIR for early, acute PJI. All patients met MSIS PJI diagnostic criteria. The median age at DAIR was 67 years (range 40-73) and 12 patients were male (75.0%). The median time to DAIR was 24 days (range 6-60). Patients were followed up for a median of 6.5 years (range1.4-10.5) following DAIR.
RESULTS: 0.3% (16/5195) of UKR in our institution had a DAIR within 3 months. 15 of 16 patients (93.8%) were culture positive, with the most common organism MSSA (n = 8, 50.0%). Patients were treated with an organism-specific intravenous antibiotic regime for a median of 6 weeks, followed by oral antibiotics for a median duration of 6 months. The Kaplan-Meier survivor estimate for revision for PJI was 57% (95%CI: 28-78%) at five years, and survivor estimate for all cause revision 52% (95%CI: 25-74%).The median Oxford Knee Score for patients with a viable implant at final follow-up was 45 points (range 39-46).
CONCLUSIONS: Early, acute PJI after UKR is rare. DAIR had a moderate success rate, with infection-free survivorship of 57% at 5 years. Those successfully treated with DAIR had excellent functional outcome and implant survival.
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