Optimizing debridement and implant retention in acute periprosthetic joint infections

Periprosthetic joint infection : development of a core outcome set

Aims

Periprosthetic joint infection (PJI) is a devastating complication of arthroplasty, with substantial morbidity, mortality, and healthcare costs. Despite advances in diagnosis and treatment, inconsistencies in outcome reporting have hindered evidence synthesis, limiting progress in understanding and management. This study aimed to develop a core outcome set (COS) for PJI to standardize outcome reporting in the literature.

Methods

A two-stage modified Delphi process was conducted to establish consensus across a range of domains. Stage 1 involved the identification of core outcomes in PJI research by an international expert panel. A patient group was also consulted to ensure that the domains were relevant to patient priorities. Stage 2 included a broader group of 55 stakeholders in an online consensus process to finalize the COS. Quantitative and qualitative data were collated to redefine the outcomes throughout the Delphi process.

Results

Following the modified two-stage Delphi process, a high level of consensus was achieved for all outcomes. The final COS included 23 outcomes across the following four domains: patient demographics and baseline characteristics; infection characteristics; surgical and treatment details; and outcomes and follow-up.

Conclusion

The developed COS provides a standardized framework for reporting outcomes in PJI research. By addressing variability and inconsistency in the literature, this COS aims to enhance comparability across studies, support robust evidence synthesis, and ultimately guide clinical decision-making.