Assessment of periprosthetic joint infection prevention methods amongst Turkish orthopedic surgeons in total joint replacement: A survey.

OBJECTIVES: This study aims to assess the methods employed by Turkish orthopedic surgeons to prevent periprosthetic joint infection (PJI) in total joint arthroplasty (TJA). PATIENTS AND METHODS: The data obtained for this study, conducted between January 2019 and February 2019, were gathered by sending out an online survey to Turkish Society of Orthopedics and Traumatology members (n=2,267). A total of 354 orthopedic surgeons responded and completed survey. The survey had 23 questions which include the experience, academic position, hospital where the physician works, monthly arthroplasty numbers, and infection prevention methods employed before, during, and after surgery. RESULTS: The period for antibiotics prophylaxis showed variability, with about 63% of surgeons using prophylaxis longer than 24 hours. In terms of academic position, 52.4% of professors and 52.8% of associate professors used prophylaxis for the first 24 hours whereas this rate was 31.3% in operators (p=0.01). Of surgeons, 50.7% who perform more than 10 arthroplasties per month and 33.6% of surgeons who perform less than 11 arthroplasties per month used 24-hour antibiotic prophylaxis (p=0.006). Blood glucose level assessment prior to surgery was performed by the majority of surgeons (94%). A total of 118 orthopedic surgeons (33.3%) performed methicillin- resistant Staphylococcus aureus (MRSA) decolonization with 54.7% of associate professors, 59.5% of professors, and 24.7% of operators (p=0.001). Only 60 surgeons (16.9%) checked vitamin D levels. CONCLUSION: Our study results demonstrated that the majority of orthopedic surgeons in Turkey do not follow the antibiotic prophylaxis recommendations and they use antibiotic prophylaxis for longer periods. Professors and associate professors, and surgeons with higher monthly arthroplasty numbers than surgeons with lower monthly arthroplasty numbers follow the recommended periods more than their counterparts. Most surgeons assess blood glucose levels whereas a small number of surgeons perform MRSA decolonization and check vitamin D levels.

The changes in preferences for venous thromboembolism prophylaxis after total joint arthroplasty in Turkey: A survey.

OBJECTIVES: This study aims to investigate the changes in preferences of orthopedic surgeons for venous thromboembolism (VTE) prophylaxis after total knee arthroplasty (TKA) and total hip arthroplasty (THA) and the factors that affect such changes in Turkey. MATERIALS AND METHODS: Turkish Orthopedics and Traumatology Association members (n=2,180) were invited to fill in the questionnaire. A total of 366 orthopedic surgeons responded and completed questionnaire. The questionnaire was comprised of 12 questions investigating the demographics of surgeons, their preferences for VTE prophylaxis, the changes in their preferences over the course of the past three years, and the causes of such changes. RESULTS: In the past three years, 31.1% of surgeons changed their VTE prophylaxis method and 32.7% used risk classifications. The use of low molecular weight heparin (LMWH) decreased from 89.4% to 42.5% and from 85.8% to 44.2% after TKA and THA, respectively. The use of aspirin increased from 10.6% to 43.4% and from 9.7% to 37.2% after TKA and THA, respectively. The use of oral anticoagulants increased from 11.5% to 41.6% and from 10.6% to 39.8% after TKA and THA, respectively. Still, orthopedic surgeons in Turkey preferred LMWH at rates of 75.7% and 74% after TKA and THA, respectively. Congressional presentations were the first (47.7%) among the causes of the changes in preferences for VTE prophylaxis. Preferences of up to 60% of surgeons working at universities were influenced by the American Academy of Orthopedic Surgeons guidelines. CONCLUSION: In the past three years, approximately one third of orthopedic surgeons changed their preferences for VTE prophylaxis after total joint arthroplasty in Turkey. Changes in preferences were largely in favor of aspirin and oral anticoagulants in parallel to changes in guidelines for VTE prevention.

[Preferences of surgeons in total knee and hip arthroplasty, and operating room facilities in Turkey: a survey]. / Türkiye'de total diz ve kalça artroplastisinde cerrahlarin tercihleri ve ameliyathane olanaklari: Bir anket.

OBJECTIVES: This study aims to determine the pre- and postoperative approaches of orthopedic surgeons and operative room environment facilities in total knee arthroplasty (TKA) and total hip arthroplasty (THA) in Turkey. MATERIALS AND METHODS: Data for this study were collected through a questionnaire completed by 234 physicians randomly identified from the database of Turkish Society of Orthopedics and Traumatology. The questionnaire comprised 19 questions investigating the operative room environment, demographic characteristics of surgeons, laboratory and radiologic analyses required by surgeons in pre- and postoperative patient evaluation, and management of postoperative complications. RESULTS: In Turkey, 48% of the operating rooms where TKA and THA are performed lack laminar airflow, while 35% lack HEPA filters. Only 20.5% of surgeons continue antibiotic prophylaxis for postoperative 24 hours. Low molecular weight heparins are the most preferred anticoagulant (86%) for thromboembolism prophylaxis. While all surgeons perform primary TKA or THA, only 63.7% perform revision TKA or THA. Of the surgeons, 84.6% do not recommended antibiotic prophylaxis before dental or urologic procedures in patients who were performed TKA or THA. CONCLUSION: In Turkey, although consensus has been built on many issues regarding TKA and THA, different approaches are adopted based on academic position, duration of specialty, and employer institution.