Improving outcomes in acute and chronic periprosthetic hip and knee joint infection with a multidisciplinary approach
| Autor: | Pauline M. Wright, John W. Kennedy, Neil D. Ritchie, Mairiosa Biddle, Brian P. Rooney, R. M. D. Meek |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Periprosthetic Knee Joint Multidisciplinary team Arthroplasty 03 medical and health sciences 0302 clinical medicine Return to Work Multidisciplinary approach infected arthroplasty Medicine Revision Knee Arthroplasty 030212 general & internal medicine Revision Hip Arthroplasty multidisciplinary team Orthopedic surgery 030222 orthopedics pji business.industry Incidence (epidemiology) Activity Level General Engineering revision surgery Surgery business RD701-811 Infected arthroplasty |
| Zdroj: | Bone & Joint Open, Vol 2, Iss 7, Pp 509-514 (2021) Bone & Joint Open |
| ISSN: | 2633-1462 |
| Popis: | Aims Periprosthetic hip and knee infection remains one of the most severe complications following arthroplasty, with an incidence between 0.5% to 1%. This study compares the outcomes of revision surgery for periprosthetic joint infection (PJI) following hip and knee arthroplasty prior to and after implementation of a specialist PJI multidisciplinary team (MDT). Methods Data was retrospectively analyzed from a single centre. In all, 29 consecutive joints prior to the implementation of an infection MDT in November 2016 were compared with 29 consecutive joints subsequent to the MDT conception. All individuals who underwent a debridement antibiotics and implant retention (DAIR) procedure, a one-stage revision, or a two-stage revision for an acute or chronic PJI in this time period were included. The definition of successfully treated PJI was based on the Delphi international multidisciplinary consensus. Results There were no statistically significant differences in patient demographics or comorbidities between the groups. There was also no significant difference in length of overall hospital stay (p = 0.530). The time taken for formal microbiology advice was significantly shorter in the post MDT group (p = 0.0001). There was a significant difference in failure rates between the two groups (p = 0.001), with 12 individuals (41.38%) pre-MDT requiring further revision surgery compared with one individual (6.67%) post-MDT inception. Conclusion Our standardized multidisciplinary approach for periprosthetic knee and hip joint infection shows a significant reduction in failure rates following revision surgery. Following implementation of our MDT, our success rate in treating PJI is 96.55%, higher than what current literature suggests. We advocate the role of a specialist infection MDT in the management of patients with a PJI to allow an individualized patient-centred approach and care plan, thereby reducing postoperative complications and failure rates. Cite this article: Bone Jt Open 2021;2(7):509–514. |
| Databáze: | OpenAIRE |
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