Effect of a multidisciplinary team on the treatment of hip and knee prosthetic joint infections : a single-centre study of 154 infections

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http://hdl.handle.net/10138/332418

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Vuorinen , M , Mäkinen , T J , Rantasalo , M & Huotari , K 2021 , ' Effect of a multidisciplinary team on the treatment of hip and knee prosthetic joint infections : a single-centre study of 154 infections ' , Infectious Diseases , vol. 53 , no. 9 , pp. 700-706 . https://doi.org/10.1080/23744235.2021.1925341

Title: Effect of a multidisciplinary team on the treatment of hip and knee prosthetic joint infections : a single-centre study of 154 infections
Author: Vuorinen, Markku; Mäkinen, Tatu Johannes; Rantasalo, Mikko; Huotari, Kaisa
Contributor organization: HUS Musculoskeletal and Plastic Surgery
Department of Surgery
I kirurgian klinikka (Töölö)
Clinicum
HUS Inflammation Center
Infektiosairauksien yksikkö
Department of Medicine
Date: 2021-09-02
Language: eng
Number of pages: 7
Belongs to series: Infectious Diseases
ISSN: 2374-4243
DOI: https://doi.org/10.1080/23744235.2021.1925341
URI: http://hdl.handle.net/10138/332418
Abstract: Background A multidisciplinary team responsible for the management plan of prosthetic joint infections (PJI) was founded in January 2008. The aim of this study was to investigate whether a decrease in the number of surgeries and length of stay (LOS) was seen in the management of PJI with the aid of the multidisciplinary team. Methods This retrospective cohort study consisted of a total of 154 postoperative PJIs from three time periods: 21 PJIs from 2005 to 2007 (Group 1), 65 PJIs from 2011 to 2013 (Group 2), and 68 PJIs from 2015 to 2016 (Group 3). Successful outcome was classified as the retention of the original implant or revised implant and no infection-related death. Results The median number of operations decreased from 2.0 operations (Group 1) to 1.0 operation (Group 3) (p = .023), and the median LOS was shortened from 49.0 days (Group 1) to 17.0 days (Group 3) (p = .000). The number of PJIs treated with two-stage exchange decreased from 52.4% (11/21, Group 1) to 16.2% (11/68, Group 3) (p = .004). Simultaneously, debridement, antibiotics, and implant retention (DAIR) as primary surgical treatment increased from 42.9% (9/21, Group 1) to 89.7% (61/68, Group 3) (p = .000). The successful outcome of DAIR improved from 55.6% (5/9, Group 1) to 85.2% (52/61, Group 3) (p = .077). Conclusions Treatment of PJI in a specialized centre with the aid of a multidisciplinary team lead to fewer surgeries and reduced LOS. Successful outcome of DAIR improved over time.
Subject: 3126 Surgery, anesthesiology, intensive care, radiology
3121 General medicine, internal medicine and other clinical medicine
Algorithm
DAIR
two-stage
operation
LOS
prosthetic joint infection
ALGORITHM
DIAGNOSIS
OUTCOMES
Peer reviewed: Yes
Rights: cc_by_nc_nd
Usage restriction: openAccess
Self-archived version: publishedVersion


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