engleski

Pro-implant foundation PJI treatment protocol in UHC Sestre Milosrdnice, Croatia, EU

With the increase of total joint arthroplasties (TJA) being performed annually in Croatia, the number of prosthetic joint infections (PJI) necessitating revision surgery is increasing. PRO implant Foundation (PIF) protocol (Charite Hospital, Berlin, Germany) suggests that sonication fluid from infected joints is more appropriate material for the diagnosis of periprosthetic infections than just periprosthetic tissue analysis. In painful joint prosthesis, with signs of premature loosening, a prosthetic infection must be ruled out by joint aspiration. One should preserve the implant only in the case of early postoperative infection (<3 weeks postoperative period), stable implant and no soft tissue lesions. In all other cases, the implant must be exchanged in one or two stages. A short interval (2-4 weeks) two-stage exchange is possible if the biofilm is susceptible to antimicrobial therapy. In the case of persistent pain after joint prosthesis upon implantation or early loosening, negative cultures must be treated as well. In this case, other (non-microbiological) criteria must be sought. By adoption of PIF diagnostic and treatment protocol sampling and sonication, our positive culture rate was raised by 19% compared to previous diagnostic protocols. With promising preliminary results (87% cured PJI), PIF paradigm of "infection as the best possible complication" is being proven in our everyday practice.

total joint arthroplasty ; joint infection ; PRO implant foundation

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