2023 ISAKOS Biennial Congress ePoster
A Multi-Disciplinary Approach for the Management of Prosthetic Joint Infections: An Australian Perspective
Christopher J. Wilson, A/Prof, MBChB, MRCS, FRACS, PhD, Adelaide, SA AUSTRALIA
James Sires, MD, Adelaide, SA AUSTRALIA
Santhosh Daniel, MD, Bedford Park, South Australia AUSTRALIA
Flinders Medical Cente, Flinders University, Adelaide, South Australia, AUSTRALIA
FDA Status Not Applicable
Summary
This study describes the philosophy and implementation of an MDT approach to the management of PJIs at a tertiary hospital in Australia. The MDT process has allowed collaboration between Orthopaedic, Infectious Disease and Microbiology departments and aims to improve quality of care provided to patients, potentially reducing morbidity and mortality of patients with PJI.
ePosters will be available shortly before Congress
Abstract
Background
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.
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
101 patients were reviewed over a 2.5-year period 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%). 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 quality of care provided to patients, potentially reducing morbidity and mortality of patients with PJI.