Page 41 - DOS Kongressen 2012 - Abstracts

A Scandinavian Survey of Treatment Routines in Prosthetic Joint
Infections after Total Hip and Knee Arthroplasty
Måns Forsberg, Eric Bekric, Christen Ravn, Søren Overgaard
Orthopedics and Traumatology Odense University Hospital; Orthopedics and
Traumatology, Odense University Hospital; Orthopedics and Traumatology,
Odense University Hospital; Orthopedics and Traumatology, Odense
University Hospital
The number of prosthetic joint infections (PJIs) after total hip
arthroplasty (THA) and total knee arthroplasty (TKA) are increasing. PJI is a
serious complication due to high related morbidity and substantial health care
expenditure. Treatment of PJI remains a controversial subject.
Purpose / Aim of Study:
Our aim was to investigate the treatment routines for
PJI in Scandinavia in a questionnaire survey.
Materials and Methods:
All clinics performing primary THA and TKA in
Scandinavia were contacted. 89 clinics met the inclusion criteria (clinics
performing PJI revision in 2011), and were willing to participate in the study ,
clinics declined to participate . The 89 clinics were divided into a hip and
knee survey and due to some clinics had the same leader, 148 anonymous
surveys were distributed (74 regarding hip and 74 regarding knee). The
surgeons were asked to state their preferred treatment in 7 constructed clinical
cases which could be answered exhaustively with the same 8 alternatives. The
cases where designed to cover different classes of infection; acute/early,
delayed, late, hematogenous spread and positive inter operative culture which
is in accordance with the recommendations of both Zimmerli and Gustilo.
Findings / Results:
surveys were completed (response rate: 79%)
representing 77 clinics. Widespread diversity in treatment routines were
registered among the clinics in Scandinavia. Statistically significant
differences were observed among the countries. There was a higher proportion
of 2 stage operation reported from Denmark and Norway compared to Sweden
in both the hip and knee survey.
We found marked differences in treatment routines of PJI
among the Scandinavian countries and within countries. This reflects that
today’s treatment strategy relies on lower evidence level and that there is no
consensus in the field.