Nonchemical Debridement in Debridement, Antibiotics, and Implant Retention Procedures for Periprosthetic Joint Infection of the Knee and Hip

Periprosthetic joint infection (PJI) is one of the most dreaded complications in arthroplasty due to patient morbidity and cost. As the median age of the American population continues to rise, total knee arthroplasty and total hip arthroplasty are increasingly used treatments. With more arthroplasty procedures performed, orthopedists are likely to face a larger number of infections. One of the major challenges of PJI treatment is the exceedingly robust and resistant nature of bacterial biofilms. These complex bacterial networks allow pathogens to evade host immune response and antibiotic therapies. Despite the development of a range of surgical and therapeutic approaches to address PJIs, further advancements are necessary to improve the outcomes of treatment for this complication. This review provides an overview of the current mechanical debridement techniques used in debridement, antibiotics, and implant retention (DAIR) procedures and briefly anticipates future innovations in the field.