From Trends to Insights: Management of Periprosthetic Joint Infections in the Past Decade in The Netherlands
Floor C. A. Koelewijn, Jesse W. P. Kuiper, Ruben Scholten, Jakob van Oldenrijk, Matthijs P. Somford, Duncan E. Meuffels, Ewout S. VeltmanThe prevention and optimal treatment of periprosthetic joint infections (PJI), including antibiotic prophylaxis and DAIR (debridement, antibiotics, and implant retention), is a controversial topic. This study evaluated treatment trends over the past 10 years in the Netherlands. In November 2024, all Dutch institutions performing total hip or knee arthroplasties were contacted to complete a 21-question survey on the availability of a protocol, antibiotic prophylaxis, and treatment of PJIs. Results were compared with previously performed surveys (2013, 2016 and 2019) to describe trends in the past decade of PJI prevention and treatment. The survey response rate was 100%. The use of single-dose antibiotic prophylaxis increased from 10% in 2016 to 49% in 2024. An acute PJI protocol was present in 72% of the institutions in 2016 and 95% in 2024. During DAIR procedures, mobile components were exchanged in 94% of the institutions, whereas in 2013 this reportedly happened in only 41%. In 77% of the institutions, a periodic multidisciplinary infection meeting is implemented, representing a 22% increase since 2013. These findings demonstrate a clear tendency towards standardization and optimization of the treatment of periprosthetic infections in the Netherlands over the past decade.