Evidence map›Paper›PMID 31641803›Full record

ReviewInternational orthopaedics2020

Twenty common errors in the diagnosis and treatment of periprosthetic joint infection.

Cheng Li, Nora Renz, Andrej Trampuz, Cristina Ojeda-Thies

Erratum issuedAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in International orthopaedics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 83 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
83citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

83 citing papers in PubMed, 7 syntheses or guidelines pooled it.

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23 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors.

Cheng LiCharité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center for Musculoskeletal Surgery (CMSC), Charitéplatz 1, 10117, Berlin, Germany.ORCID http://orcid.org/0000-0002-4080-8886
Nora RenzCharité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center for Musculoskeletal Surgery (CMSC), Charitéplatz 1, 10117, Berlin, Germany.ORCID http://orcid.org/0000-0001-8011-6684
Andrej TrampuzCharité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center for Musculoskeletal Surgery (CMSC), Charitéplatz 1, 10117, Berlin, Germany. andrej.trampuz@charite.de.ORCID http://orcid.org/0000-0002-5219-2521
Cristina Ojeda-ThiesDepartment of Traumatology and Orthopedic Surgery, Hospital Universitario 12 de Octubre, Madrid, Spain.ORCID http://orcid.org/0000-0001-7052-1491

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMisconceptions and errors in the management of periprosthetic joint infection (PJI) can compromise the treatment success. The goal of this paper is to systematically describe twenty common mistakes in the diagnosis and management of PJI, to help surgeons avoid these pitfalls. MATERIALS AND

methodsCommon diagnostic and treatment errors are described, analyzed and interpreted.

resultsDiagnostic errors include the use of serum inflammatory biomarkers (such as C-reactive protein) to rule out PJI, incomplete evaluation of joint aspirate, and suboptimal microbiological procedures (such as using swabs or collection of insufficient number of periprosthetic samples). Further errors are missing possible sources of distant infection in hematogenous PJI or overreliance on suboptimal diagnostic criteria which can hinder or delay the diagnosis of PJI or mislabel infections as aseptic failure. Insufficient surgical treatment or inadequate antibiotic treatment are further reasons for treatment failure and emergence of antimicrobial resistance. Finally, wrong surgical indication, both underdebridement and overdebridement or failure to individualize treatment can jeopardize surgical results.

conclusionMultidisciplinary teamwork with infectious disease specialists and microbiologists in collaboration with orthopedic surgeons have a synergistic effect on the management of PJI. An awareness of the possible pitfalls can improve diagnosis and treatment results.

Indexed as

Medical ErrorsAgedAnti-Bacterial AgentsBiomarkersBlood SedimentationC-Reactive ProteinDebridementDiagnostic ErrorsFemaleHumansMaleMiddle AgedProsthesis-Related InfectionsReoperationSynovial FluidTherapeutic IrrigationAnti-Bacterial AgentsBiomarkersC-Reactive ProteinHip arthroplastyJoint replacement surgeryKnee arthroplastyPeriprosthetic joint infectionSynovial fluid analysis

Identifiers

PMID31641803
PMCPMC6938795

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.