Prosthetic joint infection development of an evidence-based diagnostic algorithm

Background Increasing rates of prosthetic joint infection (PJI) have presented challenges for general practitioners, orthopedic surgeons and the health care system in the recent years. The diagnosis of PJI is complex; multiple diagnostic tools are used in the attempt to correctly diagnose PJI. Evide...

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Bibliographic Details
Published in:European journal of medical research Vol. 22; no. 1; p. 8
Main Authors: Mühlhofer, Heinrich M. L., Pohlig, Florian, Kanz, Karl-Georg, Lenze, Ulrich, Lenze, Florian, Toepfer, Andreas, Kelch, Sarah, Harrasser, Norbert, von Eisenhart-Rothe, Rüdiger, Schauwecker, Johannes
Format: Journal Article
Language:English
Published: London BioMed Central 09.03.2017
BioMed Central Ltd
Springer Nature B.V
Subjects:
Algorithms
Antibiotics
Arthroplasty, Replacement - adverse effects
Arthroplasty, Replacement - standards
Biomedicine
Care and treatment
Complications and side effects
Diagnosis
Diagnostic tests
Evidence-Based Medicine - methods
Evidence-Based Medicine - standards
Humans
Implants, Artificial
Infection
Infections
Infectious Diseases
Internal Medicine
Joint Prosthesis - microbiology
Joint surgery
Medicine
Medicine & Public Health
Oncology
Prostheses
Prosthesis
Prosthesis-Related Infections - diagnosis
Prosthesis-Related Infections - drug therapy
Staphylococcal Infections - diagnosis
Staphylococcal Infections - drug therapy
Studies
Surgeons
Surgery
TKA
Total joint replacement
Revision surgery
THA
Prosthetic joint infection
Algorithm
ISSN:2047-783X, 0949-2321, 2047-783X
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Summary:Background Increasing rates of prosthetic joint infection (PJI) have presented challenges for general practitioners, orthopedic surgeons and the health care system in the recent years. The diagnosis of PJI is complex; multiple diagnostic tools are used in the attempt to correctly diagnose PJI. Evidence-based algorithms can help to identify PJI using standardized diagnostic steps. Methods We reviewed relevant publications between 1990 and 2015 using a systematic literature search in MEDLINE and PUBMED. The selected search results were then classified into levels of evidence. The keywords were prosthetic joint infection, biofilm, diagnosis, sonication, antibiotic treatment, implant-associated infection, Staph. aureus , rifampicin, implant retention, pcr, maldi-tof, serology, synovial fluid, c-reactive protein level, total hip arthroplasty (THA), total knee arthroplasty (TKA) and combinations of these terms. Results From an initial 768 publications, 156 publications were stringently reviewed. Publications with class I–III recommendations (EAST) were considered. We developed an algorithm for the diagnostic approach to display the complex diagnosis of PJI in a clear and logically structured process according to ISO 5807. Conclusions The evidence-based standardized algorithm combines modern clinical requirements and evidence-based treatment principles. The algorithm provides a detailed transparent standard operating procedure (SOP) for diagnosing PJI. Thus, consistently high, examiner-independent process quality is assured to meet the demands of modern quality management in PJI diagnosis.
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ISSN:2047-783X
0949-2321
2047-783X
DOI:10.1186/s40001-017-0245-1