Is Treatment of Periprosthetic Joint Infection Improving Over Time? |
| |
| Institution: | 1. Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA;2. Department of Orthopaedic Surgery, General Hospital of People’s Liberation Army, Beijing, China;3. Department of Orthopaedics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan;1. Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA;2. Department of Orthopaedic Surgery, General Hospital of People''s Liberation Army, Beijing, China;3. Department of Orthopaedic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan;4. College of Medicine, Chang Gung University, Kaohsiung, Taiwan;5. Department of Orthopaedic Surgery, Shanghai Sixth People''s Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China;1. Leni and Peter W. May Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY;2. Neurospine Surgery Research Group (NSURG), Prince of Wales Private Hospital, Randwick, New South Wales, Australia;3. Institute for Healthcare Delivery Science, Department of Population Health Science and Policy/Leni and Peter W. May Department of Orthopaedic Surgery/Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY;4. Institute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY;1. Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands;2. Department of Orthopaedic Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands;3. Department of Orthopaedic Surgery, Martini Hospital, Groningen, the Netherlands;4. Department of Orthopaedic Surgery, Medical Center Leeuwarden, Leeuwarden, the Netherlands;5. Department of Medical Microbiology, Certe, Groningen, the Netherlands;1. Department of Orthopaedic Surgery, Brigham and Women’s Hospital, Boston, MA;2. Harvard Medical School, Boston, MA |
| |
| Abstract: | BackgroundIt is unknown whether the outcomes of treatment for periprosthetic joint infection (PJI) are improving with time. This study evaluated trends in PJI treatment outcomes in the hip and knee following 2-stage exchange arthroplasty and irrigation and debridement (I&D) over the last 17 years.MethodsWe reviewed 550 two-stage exchange arthroplasties and 194 I&Ds between 2000 and 2016 at our institution. Treatment success was defined according to the Delphi consensus criteria and Kaplan-Meier survivorship curves were generated. A multivariate Cox proportional hazards regression model was generated to determine time trends in the outcome of PJI treatment with the year of surgery included as both a continuous covariate (per 1-year increase) and a categorical covariate (2000-2010 or 2011-2016).ResultsThe survivorship of I&D, 2-stage revision, and the total combined cohort were comparable between 2000-2010 and 2011-2016 groups. Multivariate Cox regression analysis showed that the year of surgery was not associated with treatment failure following an I&D or 2-stage exchange arthroplasty, and neither did it increase the risk of non-reimplantation. When year of surgery was considered as a categorical variable, there remained no significant difference in treatment failure following an I&D or 2-stage exchange arthroplasty between the 2000-2010 cohort and 2011-2016 cohort.ConclusionDespite the increasing clinical focus, research advances, and growing literature relating to PJI, we were unable to detect any substantial improvement in the treatment success rates of PJI at our institution over the 17 years examined in this study. Novel treatments and techniques are certainly needed as current and prior strategies remain far from optimal. |
| |
| Keywords: | periprosthetic joint infection treatment exchange arthroplasty irrigation and debridement outcomes |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
