A UK national survey of care pathways and support offered to patients receiving revision surgery for prosthetic joint infection in the highest volume NHS orthopaedic centres

Abstract

BackgroundDeep prosthetic joint infection (PJI) is a devastating complication of joint replacement surgery. It is difficult to treat, and patients often require multiple major revision surgeries to eradicate the infection. Treatment can have negative and long‐term impact on patients' quality of life. Understanding current service provision provides valuable information needed to design and evaluate support interventions for patients.AimThis survey aimed to identify usual care pathways and support in UK National Health Service (NHS) orthopaedic centres for patients receiving revision surgery for PJI after hip or knee replacement.MethodsThe 20 highest volume NHS orthopaedic centres treating prosthetic joint infection after hip or knee replacement were approached. Consultant orthopaedic surgeons specializing in treating PJI were invited to participate in a telephone or email survey about usual care provision and support for PJI.FindingsSixteen centres completed the survey. Findings showed a high degree of variation nationally in follow‐up time‐points after revision surgery. Multidisciplinary approaches to care focused more on clinical care and physical rehabilitation than social and psychological care. Patient management and referral to support services also varied and barriers to referrals included lack of availability or access to services, lack of knowledge of services, shortage of staff, and complexities of referring outside of the hospital catchment area.ConclusionsOur findings suggest that future development of interventions should focus on more inclusive and patient‐centred multidisciplinary approaches to care. Such interventions could more completely address psychological and social as well as physical aspects of patients' recovery.

Staphylococcus aureusST228 and ST239 as models for expression studies of diverse markers during osteoblast infection and persistence

“…It is one of the main pathogens responsible for recurrent osteomyelitis (OM), accounting for 50% to 70% of cases, and prosthetic joint infections (PJIs) (Mruk & Record, 2012; Wu et al, 2019). PJIs can have a dramatic impact on a patient's quality of life, often requiring surgical intervention and prosthesis removal, as well as prolonged antibiotics treatment (Moore et al, 2017; Purrello et al, 2016; Stefani et al, 2012). These infections are often due to healthcare‐associated methicillin‐resistant S. aureus (HA‐MRSA) belonging to clonal complex 5 (Muñoz‐Gallego et al, 2017; Peng et al, 2019; Pérez‐Montarelo et al, 2018) and associated with the staphylococcal chromosomal cassette (SCC mec ) I and III (Hussain et al, 2009).…”

Evaluation of the standard procedure for the treatment of periprosthetic joint infections (PJI) in Germany - results of a survey within the EndoCert initiative

“…When comparing the register data with the knowledge of center-specific algorithms, these results may offer successful approaches for the treatment of PJI in the future. This is one of the few and one of the most comprehensive national studies on treatment of PJI [21][22][23].…”

Evaluation of The Standard Procedure for the Treatment of Periprosthetic Joint Infections (PJI) in Germany - Results of a Survey within the EndoCert Initiative

“…When matching the register data with the knowledge of centerspeci c algorithms these results may offer successful approaches in treatment of PJI. This is one of the few and one of the most comprehensive national studies on treatment of PJI (17)(18)(19).…”