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. 2017 Dec;15(4):379-385.
doi: 10.1002/msc.1186. Epub 2017 Mar 23.

A UK national survey of care pathways and support offered to patients receiving revision surgery for prosthetic joint infection in the highest volume NHS orthopaedic centres

Andrew J Moore  1 , Michael R Whitehouse  1 , Rachael Gooberman-Hill  1 , Jason Heddington  1 , Andrew D Beswick  1 , Ashley W Blom  1 , Tim J Peters  1
Affiliations

A UK national survey of care pathways and support offered to patients receiving revision surgery for prosthetic joint infection in the highest volume NHS orthopaedic centres

Andrew J Moore et al. Musculoskeletal Care. 2017 Dec.

Abstract

Background: Deep prosthetic joint infection (PJI) is a devastating complication of joint replacement surgery. It is difficult to treat, and patients often require multiple major revision surgeries to eradicate the infection. Treatment can have negative and long-term impact on patients' quality of life. Understanding current service provision provides valuable information needed to design and evaluate support interventions for patients.

Aim: This survey aimed to identify usual care pathways and support in UK National Health Service (NHS) orthopaedic centres for patients receiving revision surgery for PJI after hip or knee replacement.

Methods: The 20 highest volume NHS orthopaedic centres treating prosthetic joint infection after hip or knee replacement were approached. Consultant orthopaedic surgeons specializing in treating PJI were invited to participate in a telephone or email survey about usual care provision and support for PJI.

Findings: Sixteen centres completed the survey. Findings showed a high degree of variation nationally in follow-up time-points after revision surgery. Multidisciplinary approaches to care focused more on clinical care and physical rehabilitation than social and psychological care. Patient management and referral to support services also varied and barriers to referrals included lack of availability or access to services, lack of knowledge of services, shortage of staff, and complexities of referring outside of the hospital catchment area.

Conclusions: Our findings suggest that future development of interventions should focus on more inclusive and patient-centred multidisciplinary approaches to care. Such interventions could more completely address psychological and social as well as physical aspects of patients' recovery.

Keywords: arthroplasty; orthopaedic infections; patient-centred care; surgery.

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