Abstract
Periprosthetic Joint Infection (PJI) is a devastating complication of the Total Joint Arthroplasty (TJA). It presents a great challenge for the clinician to diagnose and manage it appropriately, with significant morbidity for the patients and cost for health care providers. The purpose of this study is to review and examine the role of multi-disciplinary team (MDT) approach in diagnosis and management of prosthetic joint infection (PJI) and how this approach can influence outcomes. All published literature examining the role of multidisciplinary care in the management of PJI and the influence of this approach to the management and outcomes of patients with this diagnosis were included. Studies published in languages other than English were excluded. There is a paucity of data on the influence of multidisciplinary care on outcomes of the management of PJI. Evidence suggests that the MDT has important role in ensuring all factors in the management of this complex group are considered and best possible care is delivered. Multicentre randomised clinical trials are required to assess the influence of MDT’S on outcome as well as important questions around the structuring of these teams.
Highlights
Introduction and backgroundProsthetic joint infection (PJI) affects about 1–3% of patients undergoing total joint arthroplasty [1]
There is no universal definition of the Periprosthetic Joint Infection (PJI)
Prolonged suppressive antibiotic therapy (PSAT): In the presence of draining sinus and well-functioning joint, or when the host suffers from serious comorbidities that could preclude surgical intervention, antibiotic suppression may lead to satisfactory results
Summary
Prosthetic joint infection (PJI) affects about 1–3% of patients undergoing total joint arthroplasty [1]. Added to this is the psychological burden associated with the issues described and its impact on post operative function [11] This combination of the knowledge that there has been a complication or suboptimal outcome, multiple surgical procedures, prolonged hospital stay, prolonged disability and associated medical comorbidities as well as social isolation and pain illustrates multiple issues which can be associated with patients presenting with PJI and the multiple facets which require management in a synchronised manner. These factors have been acknowledged in other aspects of orthopaedic surgery and it is acknowledged that optimal outcomes result from a multidisciplinary approach to management [12, 13]
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