Treatment of Periprosthetic Infection: Where and Who?

Abstract

The present work is dedicated to analysis and comparison of national and international practice standards for treatment of periprosthetic infection within a context of treatment center and speciality of physicians. The authors made a partial review of medical and legal issues related to the studied topic by the example of Russian Federation, Germany, USA, England. 118 orthopaedic surgeons were surveyed via internet aiming to evaluate the current medical practice in treatment of patients with periprosthetic infection. Survey demonstrated that there are clinical and organizational complexities in the medical care system for patients with PJI. Most often the responders reported difficulties in the medical succession and see the potential solution through creation of a network of large specialized centers. Resulting was the conclusion that physicians of all specialities should be involved in treatment of patients with periprosthetic infection. Treatment scope depends on professionalism of a physician and technical equipment of the clinic and should correspond to the best clinical practices (treatment protocols). Thus, a rapid routing of patient into more specialized hospitals. Implementation of such approach is possible with careful balancing between the quality of medical care and its proximity to the patient.