Investigation and management of prosthetic joint infection in knee replacement: A BASK Surgical Practice Guideline
Kalson NS., Mathews JA., Alvand A., Morgan-Jones R., Jenkins N., Phillips JRA., Toms AD., Baker P., Barrett D., Bloch BV., Carrington R., Eyres K., Gambhir A., Hopgood P., Howells N., Jackson WF., James P., Jeys L., Kerry R., Miles J., Mockford B., Murray J., Pavlou G., Porteous A., Price A., Sarungi M., Spencer-Jones R., Walmsley P., Waterson B., Whittaker JP.
© 2020 Elsevier B.V. Background: The burden of knee replacement prosthetic joint infection (KR PJI) is increasing. KR PJI is difficult to treat, outcomes can be poor and it is financially expensive and limited evidence is available to guide treatment decisions. Aim: To provide guidelines for surgeons and units treating KR PJI. Methods: Guideline formation by consensus process undertaken by BASK's Revision Knee Working Group, supported by outputs from UK-PJI meetings. Results: Improved outcomes should be achieved through provision of care by revision centres in a network model. Treatment of KR PJI should only be undertaken at specialist units with the required infrastructure and a regular infection MDT. This document outlines practice guidelines for units providing a KR PJI service and sets out: • The necessary infrastructure required to provide a high-quality KR PJI service • The MDT composition — who and when • The KR PJI care pathway • Medical and surgical treatment strategies • The indications for referral to tertiary units (Major Revision Centres) • Outcome metrics and auditable standards Conclusions: KR PJI patients treated within the NHS should be provided the best care possible. This report sets out guidance and support for surgeons and units to achieve this.