Duke University, Durham, North Carolina, USA
Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA.
BMJ Open Qual. 2024 Aug 21;13(3):e002921. doi: 10.1136/bmjoq-2024-002921.
Prosthetic joint infections (PJIs) following total joint arthroplasty are a significant and costly complication. To address fragmented care typically seen with separate management, we established a combined infectious disease and orthopaedic surgery clinic at Duke Health in July 2020. This clinic focuses on patients experiencing acute deterioration or multiple PJI episodes, often at the stage where amputation is the only option offered. From July 2021 to March 2024, the clinic completed 974 visits with 319 unique patients. The clinic maintained a low no-show rate of 5.0%. Treatment plans included procedures such as debridement, antibiotics and implant retention (38%), as well as implant explantation and one-stage exchange (32% each), with amputation required in only 4% of cases. The integrated clinic model facilitated real-time, multidisciplinary care, improving patient outcomes and operational efficiency. This approach offers a promising model for managing complex infections.
人工关节置换术后的假体关节感染（PJI）是一种严重且代价高昂的并发症。为了解决通常由单独管理导致的碎片化护理问题，我们于 2020 年 7 月在杜克健康中心设立了一个传染病和骨科手术联合诊所。该诊所专注于出现急性恶化或多次 PJI 发作的患者，这些患者通常处于只能接受截肢的阶段。从 2021 年 7 月到 2024 年 3 月，该诊所共完成了 974 次就诊，涉及 319 名独特的患者。该诊所的爽约率保持在 5.0%的低水平。治疗计划包括清创术、抗生素和保留植入物（38%），以及植入物取出和一期置换（各 32%），仅 4%的病例需要截肢。综合诊所模式促进了实时的多学科护理，改善了患者的预后和运营效率。这种方法为治疗复杂感染提供了一个有前途的模式。
