Variety in diagnosis and treatment of periprosthetic joint infections in Belgium and the Netherlands

Published online: Jun 27 2016

Jesse W.P. KUIPER, Stan (C.J.) VOS, Bart J. BURGER, Sascha COLEN

From the Center for Orthopaedic Research Alkmaar, Medical Center Alkmaar, the Netherlands


Recently, guidelines regarding diagnosis and treatment of periprosthetic joint infection (PJI) have been published, but it is unknown how well these are followed in the Netherlands and Belgium. Therefore, a survey study was performed in the Netherlands and Belgium. 81 orthopedic departments responded (54% in the Netherlands, 52% in Belgium). The majority used protocols for antibiotic and surgical treatment. To discriminate between early and late infection, differences in periods used were seen between respondents, and between countries. Empirical antibiotic treatment varied greatly. Debridement, antibiotics, irrigation and retention of the prosthesis (DAIR) is the almost unanimous treatment of choice for early PJI. Guidelines are available, but seem not (yet) to be followed accurately, and do not have answers to all possible treatment options. Perhaps, national guidelines might produce more standardized care, and consequentially, easier comparison for research, more transparency for patients, and less health care costs.