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Inadequate evaluation and management of suspected ­infections after TKA surgery in Lithuania : a retrospective study of 2,769 patients with 2-year follow-up

Terteliene, Egle; Grigaitis, Kazimieras; Robertsson, Otto LU ; Stucinskas, Justinas; Tarasevicius, Sarunas LU ; Porvaneckas, Narunas and Venalis, Algirdas (2019) In Acta Orthopaedica
Abstract

Background and purpose — The evidence-based algorithms for treatment of periprosthetic joint infection (PJI) recommend surgical intervention in combination with the use of systemic antibiotics. However, still it is not unusual to treat total knee arthroplasty (TKA) patients with suspected infection using only antibiotics. We investigated treatment pathways for TKA patients with suspected infection in Lithuania. Patients and methods — Of the 4,069 TKA patients (4,269 knees) registered in the Lithuanian Arthroplasty Register (2013–2015) 2,769 patients (2,825 knees) were interviewed 2 years after the surgery. The patients were asked if they had been subject to antibiotic treatment after the TKA surgery and/or if any additional surgical... (More)

Background and purpose — The evidence-based algorithms for treatment of periprosthetic joint infection (PJI) recommend surgical intervention in combination with the use of systemic antibiotics. However, still it is not unusual to treat total knee arthroplasty (TKA) patients with suspected infection using only antibiotics. We investigated treatment pathways for TKA patients with suspected infection in Lithuania. Patients and methods — Of the 4,069 TKA patients (4,269 knees) registered in the Lithuanian Arthroplasty Register (2013–2015) 2,769 patients (2,825 knees) were interviewed 2 years after the surgery. The patients were asked if they had been subject to antibiotic treatment after the TKA surgery and/or if any additional surgical interventions on the operated knee had been performed. The number of patients treated with antibiotics due to problems in the operated knee was identified and cumulative revision rates (CRR) were calculated. Results — 180 (7%) patients of the total 2,769 reported that they had been prescribed antibiotics after the primary TKA; 132 of these patients (70%) said they had received antibiotics due to problems with the operated knee. The 2-year CRR after TKA in patients not treated with antibiotics was 0.7% (95% CI 0.4–1), as compared with 24% (95% CI 17–32) in those who had used antibiotics due to the problems in the operated knee for more than 1 week. Interpretation — In Lithuania there seems to be a lack of adherence to evidence-based treatment guidelines when infection is suspected after primary TKA.

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author
organization
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Contribution to journal
publication status
epub
subject
in
Acta Orthopaedica
publisher
Taylor & Francis
external identifiers
  • scopus:85065655940
ISSN
1745-3674
DOI
10.1080/17453674.2019.1614763
language
English
LU publication?
yes
id
863555ec-faa8-4667-be4c-3ecff8a49fb8
date added to LUP
2019-06-17 12:06:32
date last changed
2019-06-19 04:16:41
@article{863555ec-faa8-4667-be4c-3ecff8a49fb8,
  abstract     = {<p>Background and purpose — The evidence-based algorithms for treatment of periprosthetic joint infection (PJI) recommend surgical intervention in combination with the use of systemic antibiotics. However, still it is not unusual to treat total knee arthroplasty (TKA) patients with suspected infection using only antibiotics. We investigated treatment pathways for TKA patients with suspected infection in Lithuania. Patients and methods — Of the 4,069 TKA patients (4,269 knees) registered in the Lithuanian Arthroplasty Register (2013–2015) 2,769 patients (2,825 knees) were interviewed 2 years after the surgery. The patients were asked if they had been subject to antibiotic treatment after the TKA surgery and/or if any additional surgical interventions on the operated knee had been performed. The number of patients treated with antibiotics due to problems in the operated knee was identified and cumulative revision rates (CRR) were calculated. Results — 180 (7%) patients of the total 2,769 reported that they had been prescribed antibiotics after the primary TKA; 132 of these patients (70%) said they had received antibiotics due to problems with the operated knee. The 2-year CRR after TKA in patients not treated with antibiotics was 0.7% (95% CI 0.4–1), as compared with 24% (95% CI 17–32) in those who had used antibiotics due to the problems in the operated knee for more than 1 week. Interpretation — In Lithuania there seems to be a lack of adherence to evidence-based treatment guidelines when infection is suspected after primary TKA.</p>},
  author       = {Terteliene, Egle and Grigaitis, Kazimieras and Robertsson, Otto and Stucinskas, Justinas and Tarasevicius, Sarunas and Porvaneckas, Narunas and Venalis, Algirdas},
  issn         = {1745-3674},
  language     = {eng},
  publisher    = {Taylor & Francis},
  series       = {Acta Orthopaedica},
  title        = {Inadequate evaluation and management of suspected ­infections after TKA surgery in Lithuania : a retrospective study of 2,769 patients with 2-year follow-up},
  url          = {http://dx.doi.org/10.1080/17453674.2019.1614763},
  year         = {2019},
}