STAPHYLOCOCCUS-AUREUS PROSTHETIC JOINT INFECTION TREATED WITH DEBRIDEMENT AND PROSTHESIS RETENTION

Debridement and retention of the prosthesis was the initial treatment modality in 30 patients with 33 Staphylococcus aureus prosthetic joint infections (PJIs) who presented to the Mayo Clinic between 1980 and 1 991. Treatment failure, defined as relapse of S. aureus Pn or occurren ce of culture-negative PJI during continuous antistaphylococcal therap y, occurred in 21 of 33 prosthetic joints. The 1-year and 2-year cumul ative probabilities of treatment failure were 54% (95% confidence inte rval [CI], 36%-71%) and 69% (95% CI, 52%-86%), respectively. A median of 4 additional surgical procedures (range, 1-9) were required to cont rol the infection in the 21 prosthetic joints for which treatment fail ed. Prostheses that were debrided > 2 days after onset of symptoms wer e associated with a higher probability of treatment failure than mere those debrided within 2 days of onset (relative risk, 4.2; 95% CI, 1.6 -10.3). These data suggest that debridement and retention of the prost hesis as the initial therapy for PJI due to S. aureus is associated wi th a high cumulative probability of treatment failure and that the pro bability of treatment failure may be related to the duration of sympto ms.