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Prosthetic joint infection development of an evidence-based diagnostic algorithm.

Abstract Increasing rates of prosthetic joint infection (PJI) have presented challenges for general practitioners, orthopedic surgeons and the health care system in the recent years. The diagnosis of PJI is complex; multiple diagnostic tools are used in the attempt to correctly diagnose PJI. Evidence-based algorithms can help to identify PJI using standardized diagnostic steps.
PMID
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Authors

Mayor MeshTerms

Algorithms

Keywords

Algorithm

Prosthetic joint infection

Revision surgery

THA

TKA

Total joint replacement

Journal Title european journal of medical research
Publication Year Start




PMID- 28274250
OWN - NLM
STAT- MEDLINE
DA  - 20170309
DCOM- 20170314
LR  - 20170314
IS  - 2047-783X (Electronic)
IS  - 0949-2321 (Linking)
VI  - 22
IP  - 1
DP  - 2017 Mar 09
TI  - Prosthetic joint infection development of an evidence-based diagnostic algorithm.
PG  - 8
LID - 10.1186/s40001-017-0245-1 [doi]
AB  - BACKGROUND: Increasing rates of prosthetic joint infection (PJI) have presented
      challenges for general practitioners, orthopedic surgeons and the health care
      system in the recent years. The diagnosis of PJI is complex; multiple diagnostic 
      tools are used in the attempt to correctly diagnose PJI. Evidence-based
      algorithms can help to identify PJI using standardized diagnostic steps. METHODS:
      We reviewed relevant publications between 1990 and 2015 using a systematic
      literature search in MEDLINE and PUBMED. The selected search results were then
      classified into levels of evidence. The keywords were prosthetic joint infection,
      biofilm, diagnosis, sonication, antibiotic treatment, implant-associated
      infection, Staph. aureus, rifampicin, implant retention, pcr, maldi-tof,
      serology, synovial fluid, c-reactive protein level, total hip arthroplasty (THA),
      total knee arthroplasty (TKA) and combinations of these terms. RESULTS: From an
      initial 768 publications, 156 publications were stringently reviewed.
      Publications with class I-III recommendations (EAST) were considered. We
      developed an algorithm for the diagnostic approach to display the complex
      diagnosis of PJI in a clear and logically structured process according to ISO
      5807. CONCLUSIONS: The evidence-based standardized algorithm combines modern
      clinical requirements and evidence-based treatment principles. The algorithm
      provides a detailed transparent standard operating procedure (SOP) for diagnosing
      PJI. Thus, consistently high, examiner-independent process quality is assured to 
      meet the demands of modern quality management in PJI diagnosis.
FAU - Muhlhofer, Heinrich M L
AU  - Muhlhofer HM
AUID- ORCID: http://orcid.org/0000-0001-9216-9038
AD  - Department of Orthopaedic Surgery, Klinikum rechts der Isar, Technische
      Universitat Munchen, Ismaninger Str. 22, 81675, Munich, Germany.
      [email protected]
FAU - Pohlig, Florian
AU  - Pohlig F
AD  - Department of Orthopaedic Surgery, Klinikum rechts der Isar, Technische
      Universitat Munchen, Ismaninger Str. 22, 81675, Munich, Germany.
FAU - Kanz, Karl-Georg
AU  - Kanz KG
AD  - Department of Trauma Surgery, Klinikum rechts der Isar, Technische Universitat
      Munchen, Ismaninger Str. 22, 81675, Munich, Germany.
FAU - Lenze, Ulrich
AU  - Lenze U
AD  - Department of Orthopaedic Surgery, Klinikum rechts der Isar, Technische
      Universitat Munchen, Ismaninger Str. 22, 81675, Munich, Germany.
FAU - Lenze, Florian
AU  - Lenze F
AD  - Department of Orthopaedic Surgery, Klinikum rechts der Isar, Technische
      Universitat Munchen, Ismaninger Str. 22, 81675, Munich, Germany.
FAU - Toepfer, Andreas
AU  - Toepfer A
AD  - Department of Orthopaedic Surgery, Klinikum rechts der Isar, Technische
      Universitat Munchen, Ismaninger Str. 22, 81675, Munich, Germany.
FAU - Kelch, Sarah
AU  - Kelch S
AD  - Department of Orthopaedic Surgery, Klinikum rechts der Isar, Technische
      Universitat Munchen, Ismaninger Str. 22, 81675, Munich, Germany.
FAU - Harrasser, Norbert
AU  - Harrasser N
AD  - Department of Orthopaedic Surgery, Klinikum rechts der Isar, Technische
      Universitat Munchen, Ismaninger Str. 22, 81675, Munich, Germany.
FAU - von Eisenhart-Rothe, Rudiger
AU  - von Eisenhart-Rothe R
AD  - Department of Orthopaedic Surgery, Klinikum rechts der Isar, Technische
      Universitat Munchen, Ismaninger Str. 22, 81675, Munich, Germany.
FAU - Schauwecker, Johannes
AU  - Schauwecker J
AD  - Department of Orthopaedic Surgery, Klinikum rechts der Isar, Technische
      Universitat Munchen, Ismaninger Str. 22, 81675, Munich, Germany.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20170309
PL  - England
TA  - Eur J Med Res
JT  - European journal of medical research
JID - 9517857
SB  - IM
MH  - *Algorithms
MH  - Arthroplasty, Replacement/adverse effects/*standards
MH  - Evidence-Based Medicine/*methods/standards
MH  - Humans
MH  - Joint Prosthesis/microbiology
MH  - Prosthesis-Related Infections/*diagnosis/drug therapy
MH  - Staphylococcal Infections/*diagnosis/drug therapy
PMC - PMC5343418
OTO - NOTNLM
OT  - *Algorithm
OT  - *Prosthetic joint infection
OT  - *Revision surgery
OT  - *THA
OT  - *TKA
OT  - *Total joint replacement
EDAT- 2017/03/10 06:00
MHDA- 2017/03/16 06:00
CRDT- 2017/03/10 06:00
PHST- 2016/09/01 [received]
PHST- 2017/02/24 [accepted]
AID - 10.1186/s40001-017-0245-1 [doi]
AID - 10.1186/s40001-017-0245-1 [pii]
PST - epublish
SO  - Eur J Med Res. 2017 Mar 9;22(1):8. doi: 10.1186/s40001-017-0245-1.

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