Articles | Volume 9, issue 2
Original full-length article
26 Apr 2024
Original full-length article |  | 26 Apr 2024

Changing the definition of treatment success alters treatment outcomes in periprosthetic joint infection: a systematic review and meta-analysis

Eytan M. Debbi, Tyler Khilnani, Ioannis Gkiatas, Yu-Fen Chiu, Andy O. Miller, Michael W. Henry, and Alberto V. Carli

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Subject: Prosthesis-related infections | Topic: Other
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Cited articles

Armstrong, M. D., Carli, A. V., Abdelbary, H., Poitras, S., Lapner, P., and Beaulé, P. E.: Tertiary care centre adherence to unified guidelines for management of periprosthetic joint infections: A gap analysis, Can. J. Surg., 61, 34–41,, 2018. 
Carli, A. V., Abdelbary, H., Ahmadzai, N., Cheng, W., Shea, B., Hutton, B., Sniderman, J., Philip Sanders, B. S., Esmaeilisaraji, L., Skidmore, B., Gauthier-Kwan, O. Y., Bunting, A. C., Gauthier, P., Crnic, A., Logishetty, K., Moher, D., Fergusson, D., and Beaulé, P. E.: Diagnostic Accuracy of Serum, Synovial, and Tissue Testing for Chronic Periprosthetic Joint Infection after Hip and Knee Replacements: A Systematic Review, J. Bone Joint Surg. Am., 101, 635–649,, 2019. 
Deng, W., Li, R., Shao, H., Yu, B., Chen, J., and Zhou, Y.: Comparison of the success rate after debridement, antibiotics and implant retention (DAIR) for periprosthetic joint infection among patients with or without a sinus tract, BMC Musculoskel. Dis., 22, 895,, 2021. 
Diaz-Ledezma, C., Higuera, C. A., and Parvizi, J.: Success after treatment of periprosthetic joint infection: A delphi-based international multidisciplinary consensus infection, Clin. Orthop. Relat. Res., 471, 2374–2382,, 2013. 
Fillingham, Y. A., della Valle, C. J., Suleiman, L. I., Springer, B. D., Gehrke, T., Bini, S. A., Segreti, J., Chen, A. F., Goswami, K., Tan, T. L., Shohat, N., Diaz-Ledezma, C., Schwartz, A. J., and Parvizi, J.: Definition of Successful Infection Management and Guidelines for Reporting of Outcomes after Surgical Treatment of Periprosthetic Joint Infection: From the Workgroup of the Musculoskeletal Infection Society (MSIS), J. Bone Joint Surg. Am., 101, e69,, 2019. 
Short summary
Reported success rates of the different surgical options to treat periprosthetic infection vary in the literature. However, these rates rely on how authors define success. The goal of this study was to determine the most commonly used definitions of success based on a classification system published by the Musculoskeletal Infection Society. We found most studies did not use the strictest definitions of success, and success rates decreased when stricter definitions were used.