Strategies for periprosthetic joint infection management in resource-limited settings: the applicability of EBJIS criteria.

IF 2 3区医学 Q2 ORTHOPEDICS

International Orthopaedics Pub Date : 2025-03-07 DOI:10.1007/s00264-025-06478-4

J Saadana, Meriam Abdeljelil, K Khemili, F Chaouch, L Saad, H Belgacem, M Jellali, A Fekih, A Toumi, A Abid

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引用次数: 0

Abstract

Background and purpose: Periprosthetic joint infection (PJI) is a significant and challenging healthcare issues. Accurate diagnosis is essential for effective treatment. The aim of our study is to underscore the usefulness of the new EBJIS definition and criteria when applied in a developing country department.

Methods: We conducted a retrospective analysis of a single-center cohort of consecutive revision arthroplasties (January 2018-June 2024). This study was carried out at the Department of Orthopedics and Trauma Surgery in the University Hospital Fattouma Bourguiba in Monastir, Tunisia. Were included in our research patients who underwent revision surgery for arthroplasties due to septic failure. Exclusion criteria were: surgery performed within the previous six weeks, antibiotic-loaded bone cement spacer in place, the second step of a two-stage revision and periprosthetic fractures.

Results: A total of 46 patients were included in the study. According to the EBJIS criteria, our cohort was divided into two groups: "likely infection" including 12 patients (26.1%) and "confirmed infection" with 34 patients (73.9%). Clinical signs like inflammation (Se 85.3%, PPV 76.32%) and pain (Se 76.47%, PPV 70.27%) demonstrate higher sensitivity but low specificity. Among paraclinical tests, a CRP level > 10 mg/dL is highly sensitive (97.06%), while PMN > 80% shows perfect specificity (100%). Tissue samples with more than two positives and cultures with the same microorganism exhibit high sensitivity (96.66% and 80%) and PPV (84.85% and 85.71%).

Conclusion: Establishing PJI diagnosis is challenging and depends on paraclinical testing. We highlight the lack of important diagnostic instruments in settings with limited resources.

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来源期刊

International Orthopaedics 医学-整形外科

CiteScore

5.50

自引率

7.40%

发文量

360

审稿时长

1 months

期刊介绍： International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters. Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable. The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.