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Periprosthetic joint infection continues to be a hot topic in orthopaedics
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For decades, periprosthetic joint infection has been focused on extensively at orthopaedic conferences, congresses and courses. However, interest in this topic has escalated during the last decade. That is good news because greater attention has always been needed to paid to periprosthetic joint infections by orthopaedic surgeons in practice and during their training.
Periprosthetic joint infection (PJI) is the most disabling complication that can occur following total joint replacement (TJR), an orthopaedic procedure that is usually expected to be highly successful. As surgeons, we are still unsure exactly why a patient develops an infection after a joint replacement.
National joint replacement registries have taught us about the incidence of the problem, and clearly PJI rates have increased worldwide during the last decade. Whether this is due to a true increase in incidence or better diagnostics is a matter still under investigation. Furthermore, recently published studies by groups in Denmark and New Zealand show that, even in the registries, the true PJI incidence is underestimated by what is thought to be about 40%.
Therefore, it is good news that a second consensus conference about PJI has been scheduled to be held 25-27 July 2018 in Philadelphia. The meeting is being organized by Javad Parvizi, MD, FRCS, of Philadelphia, and Thorsten Gehrke, MD, of Hamburg, Germany, who took the initiative in this area and organized the first consensus conference on PJI, which was held in Philadelphia in August 2013. The outcomes from that meeting were helpful to many orthopaedic societies, organizations and departments worldwide that used the information to better plan treatment of PJI.
Several issues, however, remain unresolved or have only limited evidence and these require further description and decisions. Therefore, I await the key insights and new information on PJI that result from the conclusions made at this next conference. Until then, orthopaedic surgeons worldwide who perform TJR should look to the newly published observations, results and registry data related to PJI to guide their treatment of patients with this devastating complication.
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- Per Kjaersgaard-Andersen, MD, is Chief Medical Editor of Orthopaedics Today Europe. He can be reached at Orthopaedics Today Europe, 6900 Grove Rd., Thorofare, NJ 08086, USA; email: orthopedics@healio.com.
Disclosure: Kjaersgaard-Andersen reports no relevant financial disclosures.