A Multi-Disciplinary Approach for the Management of Prosthetic Joint Infections: An Australian Perspective.

Area of Science:

• Orthopaedic Surgery
• Infectious Diseases
• Microbiology

Background:

• Prosthetic joint infections (PJIs) are serious complications of hip and knee arthroplasty.
• PJIs require a multidisciplinary approach due to complex microbiological, surgical, and host factors.
• Existing management strategies for PJIs can vary significantly.

Purpose of the Study:

• To describe the philosophy and implementation of a multidisciplinary team (MDT) approach for managing PJIs.
• To evaluate the effectiveness of an MDT in managing patients with prosthetic joint infections.

Main Methods:

• Retrospective review of patients managed by an MDT for PJIs from October 2017 to April 2020.
• Analysis of patient characteristics, microbiological profiles, and treatment strategies.
• Assessment of cure rates following surgical intervention.

Main Results:

• One hundred and one patients were reviewed over 2.5 years, with a mean age of 69.2 years.
• Common pathogens included Gram-positive organisms (42%) and Gram-negative organisms (13%).
• Management involved two-stage revision (28%), debridement-antibiotics-and-implant retention (22%), and antibiotic suppression (14%), with a 91.5% cure rate at one year for surgically treated patients.

Conclusions:

• Prosthetic joint infections necessitate coordinated care from multiple healthcare professionals.
• The MDT approach facilitates collaboration between Orthopaedics, Infectious Diseases, and Microbiology.
• This collaborative model aims to enhance the quality of PJI patient care, potentially reducing morbidity and mortality.