Research progress on debridement, antibiotics, and implant retention (DAIR) for the treatment of periprosthetic joint infection after artificial joint replacement

Periprosthetic joint infection (PJI) is one of the most serious complications following artificial joint replacement, posing significant treatment challenges and a heavy clinical burden. Debridement, antibiotics, and implant retention (DAIR) has become the preferred treatment strategy for acute PJI due to its advantages of minimal invasiveness, functional preservation, and cost-effectiveness. This article reviews the latest advances in optimizing the indications, timing of intervention, key technical details, and multimodal anti-infection strategies for DAIR. It focuses on discussing patient selection models (e.g., KLIC score), the impact of modular component exchange on biofilm eradication, the synergistic role of chemical debridement, and the central position of biofilm-active therapy in penetrating biofilms. Furthermore, this article proposes that future efforts should integrate molecular diagnostics, intelligent antimicrobial materials, and artificial intelligence prediction models to achieve individualized precision therapy for PJI, providing a theoretical basis for clinical decision-making.