What is the DAI (Direct Arterial Infusion) procedure?

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From the Research

The DAIR procedure is a recommended treatment option for early prosthetic joint infections, with a success rate of over 70% in well-selected patients, as shown in the most recent study from 2024 1.

Overview of the DAIR Procedure

The DAIR procedure involves surgically opening the infected joint, thoroughly cleaning out infected tissue and debris, removing and replacing modular components, while retaining the fixed implants. Following debridement, patients receive targeted antibiotic therapy, typically starting with broad-spectrum antibiotics intravenously for 2-6 weeks, followed by oral antibiotics for an additional 3-6 months.

Key Factors for Success

The success of the DAIR procedure depends on several key factors, including:

  • Acute infections (less than 4 weeks from symptom onset) 2
  • Well-fixed implants
  • Causative organism susceptible to biofilm-active antibiotics
  • Proper patient selection criteria
  • Close follow-up to monitor for infection resolution

Benefits of the DAIR Procedure

The DAIR procedure is preferred over complete implant removal because it:

  • Preserves bone stock
  • Reduces surgical morbidity
  • Allows faster recovery while still addressing the infection

Recent Study Findings

A recent study from 2024 found that the DAIR procedure is an effective treatment option for early prosthetic joint infections, with a success rate of over 70% in well-selected patients 1. Another study from 2022 found that the KLIC score is not useful for predicting failure in DAIR procedures, and that a specialized unit should conduct DAIR procedures 3.

Recommendations

Based on the most recent and highest quality study, the DAIR procedure is a recommended treatment option for early prosthetic joint infections, with a success rate of over 70% in well-selected patients 1. Patients should be carefully selected based on the key factors for success, and close follow-up is necessary to monitor for infection resolution. The procedure should be performed by a specialized unit, and antibiotic therapy should be tailored to the causative organism.

References

2
Research

Debridement, antibiotics and implant retention (DAIR): An effective treatment option for early prosthetic joint infections.

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy, 2021

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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