Periprosthetic infections: How do we diagnose and treat? Results of an online survey and comparison with international recommendations
Objective Endoprosthetic replacement surgery of hip and knee joints is widely performed, but always carries the risk of developing periprosthetic infection (PPI). Treatment of PPI is lengthy and demanding for the patient, often involving multiple surgeries as well as lengthy drug therapies. Remediat...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-07-01
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| Series: | Orthopaedic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/os.13052 |
| _version_ | 1819199215946956800 |
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| author | Christina Otto‐Lambertz Andreas Glauner Ayla Yagdiran Peer Eysel |
| author_facet | Christina Otto‐Lambertz Andreas Glauner Ayla Yagdiran Peer Eysel |
| author_sort | Christina Otto‐Lambertz |
| collection | DOAJ |
| description | Objective Endoprosthetic replacement surgery of hip and knee joints is widely performed, but always carries the risk of developing periprosthetic infection (PPI). Treatment of PPI is lengthy and demanding for the patient, often involving multiple surgeries as well as lengthy drug therapies. Remediation is not always successful despite extensive therapy. Methods An online survey was used to investigate whether the therapeutic measures implemented in German hospitals are based on international treatment recommendations. For this purpose, German physicians who regularly treat periprosthetic infections in their clinics were asked to complete an online questionnaire. The questionnaire asked about internal hospital procedures. These were then compared with international recommendations. Results With a response rate of 10.9%, the questionnaire shows agreement with the international recommendations in large parts of the operative and medicinal procedures. In preoperative imaging for example, two‐plane radiographs are the standard. Similarly, the participants' approach to preoperative specimen collection, incubation time, and operative management (regarding one‐ or two‐stage approach to septic joint) reflects the recommendations. Deviations were particularly evident in the area of laboratory diagnostics, where the erythrocyte sedimentation rate (ESR) is determined in only 17.1%, contrary to the recommendations. Whereas procalcitonin (PCT) and blood culture sampling takes place regularly. Clear differences emerges in the use of drains, which, contrary to the recommendations, are used very regularly (almost 70%). In this survey, the time intervals between the onset of infection symptoms and the start of therapy (prosthesis‐preserving therapy) is shown to be longer than recommended internationally. Conclusion In summary, however, the recommended approaches of the international groups in most respects are followed, a high willingness of respondents to collaborate with local infectious disease specialists demonstrates the complexity of the disease. |
| first_indexed | 2024-12-23T03:12:48Z |
| format | Article |
| id | doaj.art-321966db425542c98c7cfc504feccdfa |
| institution | Directory Open Access Journal |
| issn | 1757-7853 1757-7861 |
| language | English |
| last_indexed | 2024-12-23T03:12:48Z |
| publishDate | 2021-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj.art-321966db425542c98c7cfc504feccdfa2022-12-21T18:02:13ZengWileyOrthopaedic Surgery1757-78531757-78612021-07-011351639164510.1111/os.13052Periprosthetic infections: How do we diagnose and treat? Results of an online survey and comparison with international recommendationsChristina Otto‐Lambertz0Andreas Glauner1Ayla Yagdiran2Peer Eysel3Department of Orthopaedic Surgery University of Cologne Cologne GermanyDepartment of Radiology University of Cologne Cologne GermanyDepartment of Orthopaedic Surgery University of Cologne Cologne GermanyDepartment of Orthopaedic Surgery University of Cologne Cologne GermanyObjective Endoprosthetic replacement surgery of hip and knee joints is widely performed, but always carries the risk of developing periprosthetic infection (PPI). Treatment of PPI is lengthy and demanding for the patient, often involving multiple surgeries as well as lengthy drug therapies. Remediation is not always successful despite extensive therapy. Methods An online survey was used to investigate whether the therapeutic measures implemented in German hospitals are based on international treatment recommendations. For this purpose, German physicians who regularly treat periprosthetic infections in their clinics were asked to complete an online questionnaire. The questionnaire asked about internal hospital procedures. These were then compared with international recommendations. Results With a response rate of 10.9%, the questionnaire shows agreement with the international recommendations in large parts of the operative and medicinal procedures. In preoperative imaging for example, two‐plane radiographs are the standard. Similarly, the participants' approach to preoperative specimen collection, incubation time, and operative management (regarding one‐ or two‐stage approach to septic joint) reflects the recommendations. Deviations were particularly evident in the area of laboratory diagnostics, where the erythrocyte sedimentation rate (ESR) is determined in only 17.1%, contrary to the recommendations. Whereas procalcitonin (PCT) and blood culture sampling takes place regularly. Clear differences emerges in the use of drains, which, contrary to the recommendations, are used very regularly (almost 70%). In this survey, the time intervals between the onset of infection symptoms and the start of therapy (prosthesis‐preserving therapy) is shown to be longer than recommended internationally. Conclusion In summary, however, the recommended approaches of the international groups in most respects are followed, a high willingness of respondents to collaborate with local infectious disease specialists demonstrates the complexity of the disease.https://doi.org/10.1111/os.13052Arthroplasty exchangeCompliance to guidelineOnline surveyPeriprosthetic joint infection |
| spellingShingle | Christina Otto‐Lambertz Andreas Glauner Ayla Yagdiran Peer Eysel Periprosthetic infections: How do we diagnose and treat? Results of an online survey and comparison with international recommendations Orthopaedic Surgery Arthroplasty exchange Compliance to guideline Online survey Periprosthetic joint infection |
| title | Periprosthetic infections: How do we diagnose and treat? Results of an online survey and comparison with international recommendations |
| title_full | Periprosthetic infections: How do we diagnose and treat? Results of an online survey and comparison with international recommendations |
| title_fullStr | Periprosthetic infections: How do we diagnose and treat? Results of an online survey and comparison with international recommendations |
| title_full_unstemmed | Periprosthetic infections: How do we diagnose and treat? Results of an online survey and comparison with international recommendations |
| title_short | Periprosthetic infections: How do we diagnose and treat? Results of an online survey and comparison with international recommendations |
| title_sort | periprosthetic infections how do we diagnose and treat results of an online survey and comparison with international recommendations |
| topic | Arthroplasty exchange Compliance to guideline Online survey Periprosthetic joint infection |
| url | https://doi.org/10.1111/os.13052 |
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