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Improving outcomes in acute and chronic periprosthetic hip and knee joint infection with a multidisciplinary approach

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...

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Autores principales: Biddle, Mairiosa, Kennedy, John W., Wright, Pauline M., Ritchie, Neil D., Meek, R. M. D., Rooney, Brian P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The British Editorial Society of Bone & Joint Surgery 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8325970/
https://www.ncbi.nlm.nih.gov/pubmed/34247508
http://dx.doi.org/10.1302/2633-1462.27.BJO-2021-0064.R1
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author Biddle, Mairiosa
Kennedy, John W.
Wright, Pauline M.
Ritchie, Neil D.
Meek, R. M. D.
Rooney, Brian P.
author_facet Biddle, Mairiosa
Kennedy, John W.
Wright, Pauline M.
Ritchie, Neil D.
Meek, R. M. D.
Rooney, Brian P.
author_sort Biddle, Mairiosa
collection PubMed
description 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.
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spelling pubmed-83259702021-08-11 Improving outcomes in acute and chronic periprosthetic hip and knee joint infection with a multidisciplinary approach Biddle, Mairiosa Kennedy, John W. Wright, Pauline M. Ritchie, Neil D. Meek, R. M. D. Rooney, Brian P. Bone Jt Open Arthroplasty 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. The British Editorial Society of Bone & Joint Surgery 2021-07-12 /pmc/articles/PMC8325970/ /pubmed/34247508 http://dx.doi.org/10.1302/2633-1462.27.BJO-2021-0064.R1 Text en © 2021 Author(s) et al. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND 4.0) licence, which permits the copying and redistribution of the work only, and provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Arthroplasty
Biddle, Mairiosa
Kennedy, John W.
Wright, Pauline M.
Ritchie, Neil D.
Meek, R. M. D.
Rooney, Brian P.
Improving outcomes in acute and chronic periprosthetic hip and knee joint infection with a multidisciplinary approach
title Improving outcomes in acute and chronic periprosthetic hip and knee joint infection with a multidisciplinary approach
title_full Improving outcomes in acute and chronic periprosthetic hip and knee joint infection with a multidisciplinary approach
title_fullStr Improving outcomes in acute and chronic periprosthetic hip and knee joint infection with a multidisciplinary approach
title_full_unstemmed Improving outcomes in acute and chronic periprosthetic hip and knee joint infection with a multidisciplinary approach
title_short Improving outcomes in acute and chronic periprosthetic hip and knee joint infection with a multidisciplinary approach
title_sort improving outcomes in acute and chronic periprosthetic hip and knee joint infection with a multidisciplinary approach
topic Arthroplasty
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8325970/
https://www.ncbi.nlm.nih.gov/pubmed/34247508
http://dx.doi.org/10.1302/2633-1462.27.BJO-2021-0064.R1
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