Delegates seek better care of patients with orthopedic infections through discussion, consensus
PHILADELPHIA — Several hundred musculoskeletal and infection professionals from 98 countries joined with Jefferson Health and Rothman Institute experts this week at the International Consensus Meeting on Musculoskeletal Infection to convey their judgment on issues of prosthetic joint infection that continue to challenge the orthopedic community and to develop a consensus document that can be used to improve the care of patients affected by musculoskeletal infection.
“The second International Consensus Meeting on Musculoskeletal Infection will differ from the first meeting held in 2013,” Javad Parvizi, MD, FRCS, told Healio.com/Orthopedics.
It will involve delegates from orthopedic subspecialties in spine, trauma, foot and ankle, shoulder and elbow, oncology, pediatrics and sports, said Parvizi, an Orthopedics Today Editorial Board Member, who co-chaired the meeting with Thorsten Gehrke, MD, of Hamburg.
The meeting will culminate in about 35,000 copies of a book that presents the meeting’s outcomes in about 17 languages, Parvizi said.
Pennsylvania Sen. Larry M. Farnese Jr., Mark Tykocinski, MD, dean of Sydney Kimmel Medical College at Thomas Jefferson University, and Richard Webster, RN, MSN, NEA-BC, chief operating officer of Thomas Jefferson University Hospitals, delivered remarks on July 26, welcoming attendees on the second day of the meeting when the voting process first got underway.
What is decided at a meeting like this “truly does change care,” Webster said.
Votes in the morning of July 26 covered such topics as the effect on infection rates from prevention methods related to the patient, surgeon and operative environment, and the best, most effective diagnostic methods.
The results of one morning vote was indicative of the challenges delegates face. Some 89% of voting delegates agreed and 5% of voting delegates disagreed that use of tranexamic acid (TXA) reduces a patient’s risk of infection. For this question, 6% of delegates abstained from voting.
Jan A.N. Verhaar, MD, PhD, professor of orthopedics and chair of the department of orthopedic surgery at Erasmus University Medical Center in Rotterdam, The Netherlands, told Healio.com/Orthopedics the conundrum with a meeting like this lies in the fact that this question focused about a strategy that, in itself, is unrelated to musculoskeletal infection, but one that undoubtedly requires discussion.
The reality is the risk of infection may indeed be greater with the kind of more-involved orthopedic procedures that may involve the need for a transfusion and use of TXA, Verhaar, an Orthopaedics Today Europe Editorial Board Member, noted. However, he said there is little, if any, direct relationship between the use of TXA and musculoskeletal or periprosthetic joint infection.
The remainder of the day was planned to include voting on more general questions and continued discussion of hip and knee arthroplasty issues that were addressed the first day of the meeting. – by Susan M. Rapp
General assembly: Voting on general questions. Presented at: International Consensus Meeting on Musculoskeletal Infection; July 25-27, 2018; Philadelphia.