2.6. Evaluation of the Treatment Efficacy
±, inflammation, edema, hyperemia, pain, PJI
SCAR, INFLAMMATION, DISEASE, EDEMA, HYPEREMIA, SURGICAL SITE INFECTION
The evaluation was performed simultaneously in two ways, depending on the time since surgery (repeated replacement): evaluation of laboratory and microbiological parameters (ESR, CRP, presence and titers of the PJI pathogen and bacteriophage) in the early post-operative period and the rate of PJI relapse within 12 months after surgery:Bacteriological tests: detection and identification of the pathogen was carried out using bacteriological culture. As a study object, we used punctates (in the pre-operative period), biopsies from the inflammation site (open intra-operative biopsy), and wound fluid from drains (in the post-operative period). Microorganisms were identified using a “VITEK 2 Compact” automatic analyzer (Biomerieux, Craponne, France) or APILaboratory tests: all patients participating in the study underwent C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) tests, for laboratory monitoring of an infectious inflammatory process, on days 3 ± 1, 7 ± 1, and 12 ± 2 after surgery. CRP was evaluated with an immunoturbidimetric assay on an Integra Cobas 400 (Roche Diagnostics, Rotkreuz, Switzerland), ESR was evaluated by the Westergren method using an SRS/100II (Greiner Bio-One, Kremsmünster, Austria) automatic analyzer.Patient follow-up for PJI relapse: the treatment outcome of PJI was followed up for 12 months after surgery, and the discharge of patients from the hospital using physical examinations and phone interviews recorded as in-person and remote consultations. During surveying patients, their disease history was collected, with focus being placed on pain in the operated hip joint, temperature rises, edema, hyperemia of the post-operative scar or operated hip, possible prescription of antibiotic therapy to the patient, and revision surgery. The treatment efficacy was evaluated based on the rate of PJI relapse according to the criteria of surgical site infection: recovery from PJI considered as no PJI relapse within 12 months; no recovery from PJI considered as PJI relapse within 12 months.