Evidence-Based Protocols for the Prevention and Treatment of Prosthetic Joint Infection in Total Hip Arthroplasty: A Systematic Review

Online Journal of Surgery | Vol 1, Issue 1

Table 2. Treatment Protocols for Prosthetic JointInfection (PJI)

Protocol	Indications	Reported Outcomes
DAIR [4,6]	Acute PJI (<4 weeks); stable implant; short symptom duration	Higher failure in S. aureus (21%) vs. Streptococcus spp. (0%)
No-Spacer Protocol [2]	Severe infection or joint destruction; reduces spacer complications	33% failure rate; avoids spacer-related complications
Two-stage Revision [2,3,17,26]	Resistant/multimicrobial infections; poor soft tissue quality	High eradication (82-100%), but higher morbidity
DAPRI [7]	Modified DAIR with biofilm-targeting techniques	80% success rate; improved biofilm eradication
One-stage Revision [1,23]	Known organism, stable patient, no sinus tract or sepsis	Lower morbidity, shorter LOS, fewer complications
Muscle Flaps [30]	Large soft tissue defects or failed revision; used in limb salvage	97-100% success rate; provides durable coverage and infection control

Legend: PJI = Prosthetic Joint Infection; THA = Total Hip Arthroplasty; DAIR = Debridement, Antibiotics, Irrigation, and Retention; DAPRI = Debridement, Antibiotic Pearls, and Retention of the Implant; LOS = Length of Stay.