Overview of DAIR

Debridement and implant retention (DAIR) has curative intent for arthroplasty device infections. The procedure involves extensive surgical debridement and replacement of exchangeable components, with retention of the prosthesis. DAIR offers some advantages over exchange arthroplasty, such as reduced costs and morbidity, and a shorter stay in hospital; however, DAIR has a lower cure rate after 2 years of follow-up.

Appropriate patient selection and thorough surgical debridement are crucial to clinical success with DAIR (see Patient selection for DAIR). Surgical debridement may need to be repeated to control the infection.

In patients undergoing DAIR, give surgical antibiotic prophylaxis at the usual time before surgical incision—surgical antibiotic prophylaxis should not be delayed until after the collection of peri-prosthetic samples because this increases the risk of further infection at the surgical site.

Note: Surgical antibiotic prophylaxis should not be delayed until after the collection of peri-prosthetic samples.

Antibiotic therapy is given postoperatively and should be continued for at least 12 weeks—for choice of therapy, see Overview of empirical antibiotic therapy for arthroplasty device infectionsBernard, 2021.