- Title
- External Validation of the Joint-Specific Bone Involvement, Antimicrobial Options, Coverage of the Soft Tissues, and Host Status (JS-BACH) Classification for Predicting Outcome in Periprosthetic Joint Infections: A Cohort of 653 Patients
- Creator
- Kristensen, Nicolai K.; Manning, Laurens; Lange, Jeppe; Davis, Joshua S.
- Relation
- Journal of Arthroplasty Vol. 39, Issue 9, p. 2352-2356.e2
- Publisher Link
- http://dx.doi.org/10.1016/j.arth.2024.03.070
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2024
- Description
- Background: Periprosthetic joint infection (PJI) is a devastating complication in hip and knee joint arthroplasty. The “Joint-Specific Bone Involvement, Antimicrobial Options, Coverage of the Soft Tissues, and Host Status (JS-BACH)” classification system was developed in 2021 to stratify the complexity of PJI, and more importantly, to act as a tool to guide referrals to specialist centers. The “JS-BACH” classification has not been validated in an external cohort. This study aimed to do so using a large prospective cohort from Australia and New Zealand. Methods: We applied the JS-BACH classification to the Prosthetic Joint Infection in Australia and New Zealand Observational (PIANO) cohort. This prospective study of newly diagnosed PJI collected 2-year outcome data from 653 participants enrolled in 27 hospitals. The definition of PJI treatment failure at 24 months was any of the following: death, clinical or microbiological signs of infection, destination prosthesis removed, or ongoing antibiotic use. Individual cases were classified as per JS-BACH into “1: uncomplicated” (n = 268), “2: complex” (n = 330), and “3: limited options” (n = 55). This cohort was similar to the original JS-BACH population in terms of baseline characteristics. However, there was a difference in complexity, with more debridement, antibiotics, and implant retention procedures, fewer revision procedures, and a higher proportion of uncomplicated patients in the PIANO cohort. Results: The risk of treatment failure correlated strongly with the JS-BACH category, with odds ratios (95% confidence interval) for category 2 versus 1 of 1.75 (1.24 to 2.47) and for category 3 versus 1 of 7.12 (3.42 to 16.02). Conclusions: Despite the PIANO study population being less complicated than the original derivation cohort, the JS-BACH classification showed a clear association with treatment failure in this large external cohort.
- Subject
- arthroplasty; periprosthetic join infection; classification; revision; hip replacement; knee replacement
- Identifier
- http://hdl.handle.net/1959.13/1510312
- Identifier
- uon:56378
- Identifier
- ISSN:0883-5403
- Rights
- x
- Language
- eng
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