ICM on PJI

Statement of the EBJIS Executive Committee 

We felt as if we participated in a historic event when we returned from the International Consensus Meeting on Periprosthetic Joint Infection. After months of extensive literature research and electronic forum discussions, an extraordinary number of questions related to the preventions, diagnosis and treatment of periprosthetic joints infections were prepared. More than 300 professionals of various disciplines from more than 50 countries convened to discuss the topics in small groups resulting in a refined comprehensive document that all delegates ultimately voted on in a plenary session.

To us the results correctly, we should be equally aware of this outstanding achievement as well as its limits. To reach a consensus, a modified Delphi method was used. The oracle at Delphi was the most important myth in Greek mythology. The derived method is used in a range of health care applications, but its results cannot be deemed equivalent to practice guidelines like evidence-based medicine. The method used at this meeting was characterized by responses from a large panel of international experts.

The meeting effectively provided an unprecedented up-to-date insight into how periprosthetic infections are managed worldwide, widened our knowledge and stimulated new ideas. But scientific truth unfortunately, cannot be founded on democratic vote. Otherwise Galileo’s history would have taught nothing and we would still rely on the Oracle at Delphi. The consensus may be a part of decision making, but dogmatic application for tis use in medico-legal purposes should be avoided.

Identifying missing knowledge shall lead to ongoing research and provide answers to open questions; evidence shall replace opinion. New insights will necessitate ongoing revision of the 2013 meeting results. This much-needed consensus should be regarded not as a point of arrival, but as a big step forward in a “work in progress” in the challenging field of implant-related infections.

Carlo L. Romanò, MD
Heinz Winkler, MD
Klaus Kirketerp-Møller, MD

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EBJIS Statutes. Read the full text here.