BAJIS - Diagnosis of PJI: What Does the BOAST Say?

Description

In this presentation, Abtin Alvand discusses the critical importance of Prosthetic Joint Infection (PJI) in surgical practices, particularly its role as a leading cause of early revisions following joint replacement surgeries. He emphasizes the growing prevalence of these infections, citing a significant study from the National Joint Registry (NJR) indicating a predicted seven and a half fold increase in revision knee replacements due to infection over a decade. Alvand highlights the severe implications of PJI, including a dramatically increased mortality risk, even surpassing that of certain cancers, and emphasizes the high morbidity and costs associated with managing these infections.



Alvand draws attention to various diagnostic criteria for identifying PJI, focusing on the recent revisions provided by the ICM guidelines and the BOAST guidelines from 2020. Key indicators discussed include major criteria like the presence of a sinus tract and positive cultures, as well as recommended sampling techniques to maximize infection detection likelihood. He stresses the necessity for a multidisciplinary team (MDT) approach in managing infections throughout different phases of patient care, including preoperative, perioperative, and postoperative periods.



The presentation also underscores the importance of proper sample collection and the necessary 'antibiotic holiday' prior to sampling to avoid the complications of multi-resistant infections. Alvand concludes with a call for adherence to updated clinical guidelines to improve patient outcomes in the management of PJIs, reiterating their significant burden on patients and healthcare systems alike.

DOI: 10.1302/3114-240847

Specialties