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COVID-19 Collateral Damage: Management of Periprosthetic Joint Infection in Malaysia
Mohammed Harris Anwarali Khan1, Ren Yi Kow2, Sasidaran Ramalingam1
1Department of Orthopaedics, Hospital Kuala Lumpur, Kuala Lumpur, MYS.
Abstract:
Background and objective Periprosthetic joint infection (PJI) is one of the dreaded complications in patients after arthroplasty surgeries, owing to the risk of morbidity and arduous investigations and management associated with it. Nevertheless, as Malaysia is currently battling against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced coronavirus disease 2019 (COVID-19) pandemic head-on, the treatment for other non-life-threatening diseases including PJI has taken a backseat. In this study, we present a case series of 11 patients with PJI who were managed surgically at the largest tertiary hospital in Malaysia and we hope to shed some light on the difficulties we have encountered during this trying period. Patients and methods Patients with PJIs who underwent surgical intervention during the ongoing COVID-19 pandemic (March 1, 2020, to June 30, 2021) were reviewed and included in this study. The demographic profile of the patients, presenting complaints, prosthesis topography, biochemical investigative findings, surgical interventions, and short-term outcomes were summarized. Results A total of 11 patients were treated surgically at Hospital Kuala Lumpur for PJI. Among them, five patients are still awaiting their second-stage surgeries despite the completion of their antibiotic regimes, and they are fit for the procedure. Conclusion The COVID-19 pandemic has wreaked havoc on the treatment of patients with PJI. In a setting with scarce resources, surgeons should strongly consider single-stage revision surgeries for the treatment of patients with PJI.
Insights
Periprosthetic joint infection (PJI) treatment was delayed during the COVID-19 pandemic. Single-stage revision surgery is recommended for PJI patients in resource-limited settings.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Public Health
Background:
- Periprosthetic joint infection (PJI) is a serious complication following arthroplasty.
- The COVID-19 pandemic has disrupted non-urgent medical treatments, including PJI management.
- Malaysia faced challenges in treating PJI during the pandemic.
Purpose of the Study:
- To present a case series of PJI patients managed during the COVID-19 pandemic.
- To highlight the difficulties encountered in PJI treatment during the pandemic.
- To suggest strategies for managing PJI in resource-limited settings.
Main Methods:
- Retrospective review of 11 PJI patients who underwent surgery.
- Data collected: demographics, complaints, prosthesis details, investigations, interventions, and outcomes.
- Study period: March 1, 2020, to June 30, 2021.
Main Results:
- 11 patients with PJI were surgically treated.
- Five patients awaited second-stage surgery despite completing antibiotics.
- The pandemic significantly impacted PJI treatment timelines.
Conclusions:
- The COVID-19 pandemic severely affected PJI patient care.
- Resource limitations necessitate alternative treatment approaches.
- Single-stage revision surgery is a viable option for PJI management in such scenarios.
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