Clinical Practice Guidelines for Periprosthetic Joint InfectionsThe 13 co-authors of this article sat on a committee together to come up with Clinical Practice Guidelines (CPGs) for the diagnosis of infections in joint replacements. The proposed guidelines were approved by the American Academy of Orthopaedic Surgeons (AAOS) in June of 2010 and published here for all to see.
Clinical Practice Guidelines (CPGs) are an important tool in helping physicians keep up-to-date with what the evidence says about treatment of various problems and conditions. The goal is to improve treatment based on high-quality evidence.
CPGs are especially helpful when care for musculoskeletal problems is provided by a wide variety of health care professionals. This could include emergency medical staff, primary care physicians, physical therapists, physician assistants, chiropractors, orthopedic surgeons, athletic trainers, and others.
The 15 recommendations contained in these Clinical Practice Guidelines for the diagnosis of infections of joint replacement implants are based on a systematic review of all available research results in this area.
Ten of the 15 are based on high-quality evidence. A full viewing of all 15 is available on-line at http://www.aaos.org/research/guidelines/PJIguideline.asp. Here's a quick review of the most reliable points.
For those who are interested in these clinical practice guidelines, the authors advise remembering two additional factors that can affect decisions. First, each patient is unique and must be evaluated based on his or her situation. These guidelines are exactly that: guidelines, not a standard of practice that should be applied in a cookie-cutter fashion.
Second, health care professionals should not assume the clinical practice guidelines outlined here are set in stone or indefinite. As new studies are published, these guidelines may become outdated.
The guidelines help level the playing field, so-to-speak (everyone uses the same guidelines to direct treatment decisions). Even so, it will be necessary to update the guidelines every five years and possibly even remove them if they are outdated.
Craig Della Valle, MD, et al. Diagnosis of Periprosthetic Joint Infections of the Hip and Knee. In Journal of the American Academy of Orthopaedic Surgeons. December 2010. Vol. 18. No. 12. Pp. 760-770.
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