How I do it…. How infection doctors approach the PJI MDT
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Updated: Nov 30, 2025

Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction
Published on: December 3, 2017
Neil Jenkins1, Harriet Hughes2
1Department of Infectious Diseases, University Hospitals Birmingham NHS Foundation Trust, United Kingdom; Royal Orthopaedic Hospital, Birmingham, United Kingdom.
Abstract:
The management of prosthetic joint infection (PJI) requires discussion between experts working towards the aims and expectations of the patient. Each discipline typically does not offer a single-minded approach, but instead collectively weighs up the strengths and weaknesses of different management options. At a basic level, the infection specialist provides antimicrobial solutions based on laboratory results. During multi-disciplinary team (MDT) discussions however, they can offer additional insights into how the microbiology could influence the surgical decisions, respond to the surgical debate by designing a rational approach to antimicrobials and contribute to an option-appraisal that can be presented to the patient. In this short opinion piece, we describe some of the thoughts we have during MDT discussions to ultimately recommend an optimised treatment plan for the individual patient: is there infection? what is the pathogen? where did it come from? (and where else has it gone), and what is the best treatment strategy?
Insights
Managing prosthetic joint infection (PJI) needs expert collaboration. Multidisciplinary teams (MDTs) optimize patient treatment by integrating infection and surgical insights for the best strategy.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Medical Microbiology
Background:
- Prosthetic joint infection (PJI) management demands a collaborative approach.
- Individual medical disciplines often have differing perspectives on PJI treatment.
- Optimal PJI care requires integrating expertise from multiple specialties.
Purpose of the Study:
- To outline the thought process during multidisciplinary team (MDT) discussions for PJI.
- To emphasize the collaborative decision-making in optimizing PJI treatment strategies.
- To highlight the role of infection specialists within MDTs for PJI.
Main Methods:
- This opinion piece describes the considerations during MDT meetings for PJI.
- It focuses on the integration of microbiological data with surgical planning.
- The authors detail their approach to patient-centered PJI management.
Main Results:
- MDT discussions facilitate a comprehensive appraisal of PJI management options.
- Infection specialists contribute crucial insights into antimicrobial strategies influenced by microbiology.
- This collaborative approach leads to optimized, individualized treatment plans for PJI patients.
Conclusions:
- Effective PJI management relies on multidisciplinary collaboration.
- Integrating infection and surgical expertise ensures a rational and patient-centered approach.
- The MDT process is essential for determining the best treatment strategy for prosthetic joint infections.
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