A protocol for periprosthetic joint infections from the Northern Infection Network for Joint Arthroplasty (NINJA) in the Netherlands

W P Zijlstra; J J W Ploegmakers; G A Kampinga; M L Toren-Wielema; H B Ettema; B A S Knobben; P C Jutte; M Wouthuyzen-Bakker; Northern Infection Network for Joint Arthroplasty (NINJA)

doi:10.1186/s42836-022-00116-9

A protocol for periprosthetic joint infections from the Northern Infection Network for Joint Arthroplasty (NINJA) in the Netherlands

Arthroplasty. 2022 Apr 11;4(1):19. doi: 10.1186/s42836-022-00116-9.

Authors

W P Zijlstra¹, J J W Ploegmakers², G A Kampinga³, M L Toren-Wielema⁴, H B Ettema⁵, B A S Knobben⁶, P C Jutte², M Wouthuyzen-Bakker⁷; Northern Infection Network for Joint Arthroplasty (NINJA)

Collaborators

Northern Infection Network for Joint Arthroplasty (NINJA):
A Al Moujahid, P F Doorn, B L E F Ten Have, G Mithoe, L E Pirii, I N Vlasveld, M Stevens, M G A van Vonderen, A J de Vries

Affiliations

¹ Department of Orthopedic Surgery, Medical Center Leeuwarden, Leeuwarden, the Netherlands.
² Department of Orthopedic Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
³ Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
⁴ Department of Pharmacy, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
⁵ Department of Orthopedic Surgery, Isala Clinics, Zwolle, the Netherlands.
⁶ Department of Orthopedic Surgery, Martini Hospital, Groningen, the Netherlands.
⁷ Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. m.wouthuyzen-bakker@umcg.nl.

Abstract

Periprosthetic joint infection (PJI) is a devastating complication of joint arthroplasty surgery. Treatment success depends on accurate diagnostics, adequate surgical experience and interdisciplinary consultation between orthopedic surgeons, plastic surgeons, infectious disease specialists and medical microbiologists. For this purpose, we initiated the Northern Infection Network for Joint Arthroplasty (NINJA) in the Netherlands in 2014. The establishment of a mutual diagnostic and treatment protocol for PJI in our region has enabled mutual understanding, has supported agreement on how to treat specific patients, and has led to clarity for smaller hospitals in our region for when to refer patients without jeopardizing important initial treatment locally. Furthermore, a mutual PJI patient database has enabled the improvement of our protocol, based on medicine-based evidence from our scientific data. In this paper we describe our NINJA protocol.Level of evidence: III.

Keywords: Arthroplasty Surgery; Debridement Antibiotics and Implant Retention (DAIR); Periprosthetic joint infection (PJI); Protocol; Treatment.