International leaders in orthopedic surgery gathered in Philadelphia at Thomas Jefferson University and Hospitals recently to establish the guidelines for preventing and treating joint infections.
Periprosthetic joint infections (PJI), infections that can develop deep inside a prosthesis following joint replacement surgery are the most common reason for revisions (the re-opening of the joint) after knee replacement and the third most frequent reason for revisions after total hip replacements.
Even more troubling, these infections claim the lives of one in eight of patients who develop one and cost the health care system approximately $900 million to treat. It is also a serious concern as a growing number of people require joint replacement surgery including many who have existing health concerns such as obesity and heart disease. Moreover, as antibiotic-resistance organisms become more prevalent, such infections have the potential to have more significant impact on these patients.
To address these and other issues, Javad (Jay) Parvizi, MD, director of Research at the Rothman Institute at Jefferson and current president of the Musculoskeletal Infection Society, and Thorsten Gehrke, MD, a joint surgeon from Germany recently convened more than 300 delegates from 54 countries to establish the “Bible” for the treatment and prevention of periprosthetic joint infections.
The International Consensus Meeting was held on the Jefferson campus followed by the annual meeting of the Musculoskeletal Infection Society.
“The magnitude of this effort is unheard of,” says Dr. Parvizi.
This “International Consensus Group,” a hand-picked collection of international experts in orthopedic surgery, infectious diseases, wound treatment and science as well as representatives from the U.S. Centers for Disease Control and Prevention, the National Institutes of Health and the Food and Drug Administration as well as device manufacturers all came together to determine the guidelines.
Before this meeting no internationally agreed-upon treatment for PJI existed.
“One surgeon may wash their hands five minutes with one agent, another may wash for one minute with another agent,” Dr. Parvizi explained to KYW Newsradio for a story on the conference, “so that’s why we had the world’s experts sit here and decide which of those practices were the right thing to do for the patients.”
Dr. Parvizi and the Rothman Institute at Jefferson have conducted and published much of the existing research on PJI.
When they arrived in Philadelphia, the delegates had already read, reviewed and edited to their respective sections of the consensus document. Their time in Philadelphia finalized the recommendations of each “workgroup” and the meeting culminated in an all-group meeting to vote on the entire document. The group came to consensus on 80 percent of the topics discussed and recommended further research in the areas where they did not.
The results will now be published and become the worldwide standard for orthopedic surgeons and others treating joint infection.