A Multi-Disciplinary Approach for the Management of Prosthetic Joint Infections: An Australian Perspective
https://doi.org/10.5704/MOJ.2207.005
- Author:
Sires JD
1
,
2
;
Pham K
1
;
Daniel S
3
;
Inglis M
2
;
Wilson CJ
1
,
2
Author Information
1. College of Medicine and Public Health, Flinders University, Adelaide, Australia&
2. Department of Orthopaedic Surgery, Flinders Medical Centre, Adelaide, Australia
3. Department of Microbiology and Infectious Diseases, Flinders Medical Centre, Adelaide, Australia
- Publication Type:Journal Article
- Keywords:
prosthetic joint infection, revision surgery, multidisciplinary team, total knee arthroplasty, total hip arthroplasty
- From:Malaysian Orthopaedic Journal
2022;16(No.2):41-45
- CountryMalaysia
- Language:English
-
Abstract:
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 lifethreatening 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% Gramnegative 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.
- Full text:16.2022my1247.pdf
