Table 1.
Different definitions of success and failure in treatment of PJIs
| Study | Setting/ treatment | Definition of success | Definition of failure |
|---|---|---|---|
| Volin et al. [41] | Two-stage revision | Treatment was considered successful if the patient was disease free at the latest followup | |
| Jämsen et al. [17] | Meta-analysis | Success in infection management was analyzed in three ways. First, the total number of infections appearing after treatment was recorded, supplemented by the number of recurrent infections and of new infections (that is, postoperative infections caused by an organism other than the one detected on treatment) | |
| Bradbury et al. [6] | Open débridement and component retention | Clinical resolution of infection and lack of further surgery. Patients who had clinical resolution of infection but were maintained on suppressive oral antibiotics were considered to have successful treatment | Need for subsequent infection-related surgery |
| Waagsbø et al. [42] | Open débridement and component retention | Treatment response was defined as postdébridement period free from PJI relapse during the time of followup | Need of further orthopaedic surgery |
| Azzam et al. [2] | Open débridement and component retention | Absence of symptoms and signs of infection until the date of the last followup | Need for resection arthroplasty or recurrent microbiologically proven infection |
| Estes et al. [14] | Two-stage revision | Success was considered as infection control. Serum inflammatory markers (ESR and CRP) had normalized and there were no clinical signs or symptoms of infection | Recurrence of infection requiring additional surgery or clinically apparent infection diagnosed with a positive aspiration or persistently elevated inflammatory markers and treated with long-term antibiotic suppression |
| Parvizi et al. [31] | Methicillin resistant Staphylococcus aureus PJI | Infection eradication | |
| Senneville et al. [37] | S aureus PJI | Remission was defined by the absence of local or systemic signs of infection assessed during the most recent contact with the patient and absence of the need to reoperate or to administer antibiotic therapy directed to the initial infected site from the end of treatment to the most recent contact | Any other outcome, including death related to the PJI. |
| El Helou et al. [13] | Two-stage revision | Treatment failure was defined by one of the following criteria: (1) recurrence of PJI caused by the same strain of microorganism or a different microorganism at any time after reimplantation surgery; (2) death caused by prosthesis-related infection at any time after reimplantation surgery; (3) clinical failure defined as clinical, laboratory, or radiographic findings suggestive of PJI at any time after reimplantation surgery | |
| Mahmud et al. [23] | Two-stage revision | Any outcome different from failure (no clear definition was stated) | Any patient who required additional surgery for either septic or aseptic reasons following two-stage revision. Septic failure was defined as pain and/or loose prosthesis with an increased CRP and positive culture from joint aspiration, and/or intraoperative histology consistent with infection |
PJI = periprosthetic joint infection; ESR = erythrocyte sedimentation rate; CRP = C-reactive protein.