AUTHOR=Naufal Elise , Wouthuyzen-Bakker Marjan , Babazadeh Sina , Stevens Jarrad , Choong Peter F. M. , Dowsey Michelle M. TITLE=Methodological Challenges in Predicting Periprosthetic Joint Infection Treatment Outcomes: A Narrative Review JOURNAL=Frontiers in Rehabilitation Sciences VOLUME=3 YEAR=2022 URL=https://www.frontiersin.org/journals/rehabilitation-sciences/articles/10.3389/fresc.2022.824281 DOI=10.3389/fresc.2022.824281 ISSN=2673-6861 ABSTRACT=

The management of periprosthetic joint infection (PJI) generally requires both surgical intervention and targeted antimicrobial therapy. Decisions regarding surgical management–whether it be irrigation and debridement, one-stage revision, or two-stage revision–must take into consideration an array of factors. These include the timing and duration of symptoms, clinical characteristics of the patient, and antimicrobial susceptibilities of the microorganism(s) involved. Moreover, decisions relating to surgical management must consider clinical factors associated with the health of the patient, alongside the patient's preferences. These decisions are further complicated by concerns beyond mere eradication of the infection, such as the level of improvement in quality of life related to management strategies. To better understand the probability of successful surgical treatment of a PJI, several predictive tools have been developed over the past decade. This narrative review provides an overview of available clinical prediction models that aim to guide treatment decisions for patients with periprosthetic joint infection, and highlights key challenges to reliably implementing these tools in clinical practice.