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Home/Large Joints and Extremities/Bristol Researchers Take on Joint Infection Study
Large Joints and Extremities

Bristol Researchers Take on Joint Infection Study

June 16, 2017 1 min read Premium comments

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Bristol Researchers Take on Joint Infection Study
Lead Investigator Ashly Blom Addressing Musculoskeletal Issues / Courtesy of NIHR Collaboration for Musculoskeletal Health
Secondary

The University of Bristol, United Kingdom, has taken on the solving of a major medical mystery. The mystery is why do about 1% of patients getting a hip or knee joint replacement, develop a joint infection. Called a periprosthetic joint infection (PJI) it often results in severe physical and emotional suffering. Treatment options include the removal of damaged or dead tissue; re-doing the joint replacement; removal of the joint; and amputation. Members of the public have been invited to participate in the study.

The trial’s primary focus is on patient reported outcomes: pain, stiffness, and wellbeing in the long-term. The trial will also compare the cost-effectiveness, complications and re-infection rates among these surgical interventions. An interview study will explore patients’ and surgeons’ experiences, including their views about trial participation and randomization.

Researchers have recruited over 80 patients with periprosthetic joint infection of the hip, from 14 orthopedic hospitals in England and Wales and 6 hospitals in Sweden.

Ashley Blom, MBChB, MD, PhD, FRCS, FRCS (Tr&Orth), professor of orthopaedic surgery in the School of Clinical Sciences and Joint Head of the Musculoskeletal Research Unit, said: “Over 160,000 primary hip or knee replacements were carried out in England, Wales and Northern Ireland in 2016. About one person in 100 developed a bacterial infection at their new, artificial joint. Patients with infected joint replacements have described the experience as ‘devastating’ and ‘associated with ‘unbearable suffering’. If untreated, these infections can result in severe pain, persistent dislocation or death.”

Blom added that patients tell him that pain, function and long-term wellbeing are what is most important to them and that these are more important outcomes than those measured in previous non-randomized studies. “We hope the results of the trial will benefit patients in the future,” he said.

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Discussion

14
DS
Dr. Sarah MitchellOrthopedic Surgeon · Mayo Clinic

This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?

8
JT
James Thornton, MDSpine Fellow · HSS

Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.

5
RP
R. PatelSports Medicine · Stanford

We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.

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