A Multi-Disciplinary Approach for the Management of Prosthetic Joint Infections: An Australian Perspective
INTRODUCTION: Prosthetic joint infections (PJI) are a major complication of hip and knee arthroplasty, imposing significant morbidity and mortality. Orthopaedic oncology units have utilised a multi-disciplinary team (MDT) approach for some time. PJI is not only an equally life- threatening condition...
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| Format: | Article |
| Language: | English |
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Malaysian Orthopaedic Association
2022-07-01
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| Series: | Malaysian Orthopaedic Journal |
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| Online Access: | http://morthoj.org/2022/v16n2/prosthetic-joint-infection.pdf |
| _version_ | 1811321250332540928 |
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| author | Sires JD Pham K Daniel S Inglis M Wilson CJ |
| author_facet | Sires JD Pham K Daniel S Inglis M Wilson CJ |
| author_sort | Sires JD |
| collection | DOAJ |
| description | INTRODUCTION: Prosthetic joint infections (PJI) are a major complication of hip and knee arthroplasty, imposing significant morbidity and mortality. Orthopaedic oncology units have utilised a multi-disciplinary team (MDT) approach for some time. PJI is not only an equally life- threatening condition, it also requires input from multiple healthcare personnel and treatment can vary significantly between individuals given the diversity in microbiological, surgical and host factors. Our arthroplasty service established an MDT meeting to manage this complex patient group. This study describes the philosophy and implementation of an MDT approach to the management of PJIs at a tertiary hospital in Australia.
MATERIALS AND METHODS: A retrospective review of all patients that presented to the MDT PJI meeting from October 2017 to April 2020 was performed. Patient characteristics, microbiological profile and management were reviewed.
RESULTS: One hundred and one patients were reviewed over 2.5 years with a mean age of 69.2 years (SD 11.9). Patients presenting predominantly had a primary TKR (32%) or primary THR (22%). Results of Microbiology cultures varied, with 42% Gram-positive organisms, 13% Gram- negative organisms, 2% fungus and 1% yeast origin. Management mainly consisted of two-stage revision (28%), debridement-antibiotics-and-implant retention (22%) and antibiotic suppression (14%). A total of 91.5% of patients who underwent surgical management were considered cured at one year.
CONCLUSION: PJIs are complex and require coordinated care by a number of healthcare personnel. The MDT process has allowed collaboration between Orthopaedic, Infectious Disease and Microbiology departments and aims to improve the quality of care provided to patients, potentially reducing morbidity and mortality of patients with PJI. |
| first_indexed | 2024-04-13T13:14:40Z |
| format | Article |
| id | doaj.art-fa2629dc1890450cb65c8aa4dc4f4417 |
| institution | Directory Open Access Journal |
| issn | 1985-2533 2232-111X |
| language | English |
| last_indexed | 2024-04-13T13:14:40Z |
| publishDate | 2022-07-01 |
| publisher | Malaysian Orthopaedic Association |
| record_format | Article |
| series | Malaysian Orthopaedic Journal |
| spelling | doaj.art-fa2629dc1890450cb65c8aa4dc4f44172022-12-22T02:45:31ZengMalaysian Orthopaedic AssociationMalaysian Orthopaedic Journal1985-25332232-111X2022-07-01162414510.5704/MOJ.2207.005A Multi-Disciplinary Approach for the Management of Prosthetic Joint Infections: An Australian PerspectiveSires JD0Pham K1Daniel S2Inglis M3Wilson CJ4MS OrthBPharmFRACPFRACSPhDINTRODUCTION: Prosthetic joint infections (PJI) are a major complication of hip and knee arthroplasty, imposing significant morbidity and mortality. Orthopaedic oncology units have utilised a multi-disciplinary team (MDT) approach for some time. PJI is not only an equally life- threatening condition, it also requires input from multiple healthcare personnel and treatment can vary significantly between individuals given the diversity in microbiological, surgical and host factors. Our arthroplasty service established an MDT meeting to manage this complex patient group. This study describes the philosophy and implementation of an MDT approach to the management of PJIs at a tertiary hospital in Australia. MATERIALS AND METHODS: A retrospective review of all patients that presented to the MDT PJI meeting from October 2017 to April 2020 was performed. Patient characteristics, microbiological profile and management were reviewed. RESULTS: One hundred and one patients were reviewed over 2.5 years with a mean age of 69.2 years (SD 11.9). Patients presenting predominantly had a primary TKR (32%) or primary THR (22%). Results of Microbiology cultures varied, with 42% Gram-positive organisms, 13% Gram- negative organisms, 2% fungus and 1% yeast origin. Management mainly consisted of two-stage revision (28%), debridement-antibiotics-and-implant retention (22%) and antibiotic suppression (14%). A total of 91.5% of patients who underwent surgical management were considered cured at one year. CONCLUSION: PJIs are complex and require coordinated care by a number of healthcare personnel. The MDT process has allowed collaboration between Orthopaedic, Infectious Disease and Microbiology departments and aims to improve the quality of care provided to patients, potentially reducing morbidity and mortality of patients with PJI.http://morthoj.org/2022/v16n2/prosthetic-joint-infection.pdfprosthetic joint infectionrevision surgerymultidisciplinary teamtotal knee arthroplastytotal hip arthroplasty |
| spellingShingle | Sires JD Pham K Daniel S Inglis M Wilson CJ A Multi-Disciplinary Approach for the Management of Prosthetic Joint Infections: An Australian Perspective Malaysian Orthopaedic Journal prosthetic joint infection revision surgery multidisciplinary team total knee arthroplasty total hip arthroplasty |
| title | A Multi-Disciplinary Approach for the Management of Prosthetic Joint Infections: An Australian Perspective |
| title_full | A Multi-Disciplinary Approach for the Management of Prosthetic Joint Infections: An Australian Perspective |
| title_fullStr | A Multi-Disciplinary Approach for the Management of Prosthetic Joint Infections: An Australian Perspective |
| title_full_unstemmed | A Multi-Disciplinary Approach for the Management of Prosthetic Joint Infections: An Australian Perspective |
| title_short | A Multi-Disciplinary Approach for the Management of Prosthetic Joint Infections: An Australian Perspective |
| title_sort | multi disciplinary approach for the management of prosthetic joint infections an australian perspective |
| topic | prosthetic joint infection revision surgery multidisciplinary team total knee arthroplasty total hip arthroplasty |
| url | http://morthoj.org/2022/v16n2/prosthetic-joint-infection.pdf |
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