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临床试验/NCT05640336
NCT05640336Enrolling By Invitation不适用

Single vs Planned Double-Debridement Antibiotics and Implant Retention Followed by Chronic Antibiotic Suppression for the Treatment of Acute Periprosthetic Joint Infection: A Prospective, Multicenter, Randomized Clinical Trial

Mayo Clinic4 个研究点 分布在 1 个国家目标入组 490 人开始时间: 2023年3月3日最近更新:
适应症

试验速览

阶段
不适用
状态
Enrolling By Invitation
发起方
Mayo Clinic
入组人数
490
试验地点
4
主要终点
Subjects free from failure

研究概览

简要总结

The purpose of this research is to evaluate two different standard of care surgeries in treating periprosthetic joint infection (PJI) after total hip and knee arthroplasty. Researchers are looking at differences in outcomes following single versus planned double debridement, antibiotics, and implant retention (DAIR) for acutely infected total hip arthroplasty (THA), and total knee arthroplasties (TKAs).

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Parallel
主要目的
Treatment
盲法
None

入排标准

年龄范围
18 Years 至 —(Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • Patients who speak English and are willing to sign the consent form
  • Patients with acute early postoperative infection (symptoms ≤ 4 weeks from surgery; symptoms < 4 weeks in duration) and acute hematogenous infection (greater than 4 weeks from surgery; symptoms < 3 weeks in duration) of a primary total knee or total hip arthroplasty, defined as:
  • A sinus communicating with the prosthesis OR
  • Two positive cultures obtained from the prosthesis OR
  • 4 of 5 criteria: Elevated ESR (> 30mm/hr) and CRP (> 10mg/L); Elevated synovial leukocyte count (>3000 cells/μL) or change of ++ on; leukocyte esterase strip; Elevated synovial neutrophil percentage (> 80%); One positive culture; Positive histological analysis of periprosthetic tissue (> 5 neutrophils per high; Power field in 5 high power fields x 400).
  • OR Patient with an acute infection diagnosed clinically by an orthopedic surgeon treated with DAIR

排除标准

  • Patients with a chronic PJI, defined as: presentation of symptoms > 4 weeks in duration.
  • Revision surgery or previous two-stage reimplantation.

结局指标

主要结局

Subjects free from failure

时间窗: 1 year following DAIR.

Total number of subjects considered failure free at one year from surgical DAIR procedure. Failure is defined as reoperation for infection within one year from surgical procedure.

次要结局

  • Adverse events(10 years following DAIR procedure)
  • 1-year surgical reoperation rate(1 year following DAIR procedure)
  • Clinical Outcome Scores(1, 5, and 10 years following DAIR procedure)
  • 10-year surgical revision rate(10 years following DAIR procedure)
  • Hospital length of stay(Approximately 2 weeks following DAIR procedure)
  • Resource analysis(Approximately 2 weeks following DAIR procedure)
  • Readmission within 90 days of the surgical DAIR procedure(90 days following DAIR procedure)
  • 5-year surgical reoperation rate(5 years following DAIR procedure)
  • Survivorship(10 years following DAIR procedure)

研究者

发起方
Mayo Clinic
申办方类型
Other
责任方
Principal Investigator
主要研究者

Matthew P. Abdel, M.D.

Principal Investigator

Mayo Clinic

研究点 (4)

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