Naufal Elise, Wouthuyzen-Bakker Marjan, Babazadeh Sina, Stevens Jarrad, Choong Peter F M, Dowsey Michelle M
Department of Surgery, St Vincent's Hospital Melbourne, University of Melbourne, Fitzroy, VIC, Australia.
Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
Front Rehabil Sci. 2022 Jul 11;3:824281. doi: 10.3389/fresc.2022.824281. eCollection 2022.
The management of periprosthetic joint infection (PJI) generally requires both surgical intervention and targeted antimicrobial therapy. Decisions regarding surgical management-whether it be irrigation and debridement, one-stage revision, or two-stage revision-must take into consideration an array of factors. These include the timing and duration of symptoms, clinical characteristics of the patient, and antimicrobial susceptibilities of the microorganism(s) involved. Moreover, decisions relating to surgical management must consider clinical factors associated with the health of the patient, alongside the patient's preferences. These decisions are further complicated by concerns beyond mere eradication of the infection, such as the level of improvement in quality of life related to management strategies. To better understand the probability of successful surgical treatment of a PJI, several predictive tools have been developed over the past decade. This narrative review provides an overview of available clinical prediction models that aim to guide treatment decisions for patients with periprosthetic joint infection, and highlights key challenges to reliably implementing these tools in clinical practice.
人工关节周围感染（PJI）的管理通常需要手术干预和针对性的抗菌治疗。关于手术管理的决策——无论是冲洗清创、一期翻修还是二期翻修——都必须考虑一系列因素。这些因素包括症状出现的时间和持续时间、患者的临床特征以及所涉及微生物的抗菌药敏情况。此外，与手术管理相关的决策必须在考虑患者偏好的同时，兼顾与患者健康相关的临床因素。除了单纯根除感染之外，诸如与管理策略相关的生活质量改善水平等问题，使这些决策更加复杂。为了更好地了解PJI手术治疗成功的可能性，在过去十年中已经开发了几种预测工具。本叙述性综述概述了旨在指导人工关节周围感染患者治疗决策的现有临床预测模型，并强调了在临床实践中可靠应用这些工具的关键挑战。
