A modified Delphi consensus on periprosthetic infection in orthopaedic oncology : a report from the Birmingham Orthopaedic Oncology Meeting (BOOM)

Lee Jeys; Eduardo Botello; Richard A. Boyle; Walid Ebeid; Matthew T. Houdek; Vineet J. Kurisunkal; Rhidian Morgan-Jones; Guy V. Morris; Ajay Puri; Pietro Ruggieri; BOOM Consensus Meeting Participants; Minna K. Laitinen; Santiago Abad Repiso; Hesham Abdelbary; Alejandro Abiad Mejia; Ahmed A. Abood; Ghaith Abou-Nouar; Juan C. Abril Martin; Ayman Abu Elhamd; Adesegun Abudu; Marthelena Acosta; Keisuke Ae; Manish Agarwal; Vivek Ajit Singh; Toru Akiyama; Jose I. Albergo; John Alexander; Patricio A. Alfaro; Bugra Alpan; Ibrahim Alshaygy; Jose Amaya-Valero; Megan Anderson; Dimosthenis Andreou; Lucas Annabell; Christopher Anthony; Ahmed Aoude; Iraia Arteagoitia-Colino; Apichat Asavamongkolkul; William Aston; Libe Asua Mentxaka; Christine Azzopardi; Thomas Baad-Hansen; Ismail T. Badr; Francisco Baixauli-Garcia; Gavin Baker; Tessa Balach; Giacomo G. Baldi; Janie Barry; Georges Basile; Stefano Bastoni; Mohammad Hardian Basuki; Henrik Bauer; Lee Bayliss; Ricardo G. Becker; Angad Bedi; Joseph Benevenia; Francisco Bengoa; Peter Bergh; Marko Bergovec; Nicholas Bernthal; Odion Binitie; David Boddie; Michele Boffano; Patricia Bonilla Huertas; Anna B. Borgognoni; Rajesh Botchu; Jos Bramer; Harriet Branford-White; Rahat Brar; Demien Broekhuis; Samuel E. Broida; Tymoteusz Budny; Zachary Dc Burke; Jorge Cabrolier; Jorge R. Calvo Tapies; Jose A. Calvo-Haro; Dominico Campanacci; Rodrigo Cardoso; Richard Carey Smith; Pedro I. Carvallo; Nicolas Casales Fresenga; Jose Manuel Casanova; Oscar Ceballos; Juan Luis Cebrian Parra; Laura K. Certain; Sara Chacon Cartaya; Chung Ming Chan; Yoon Joo Cho; Peter Choong; Yang-Guk Chung; Dawid Ciechanowicz; Miguel Angel Clara-Altamirano; David Clever; Sebastian Matheo Colina; Luis Consuegra; Cory Couch; Gillian Cribb; Carlos Cuervo; Laurence A. Cusick; Solomon Dadia; Tanios Dagher; Dietmar Dammerer; Mark Davies; Nerys Davies; Luis Pablo de la Rosa Martino; Francisco Javier de Santos de la Fuente; Marieke de Vaal; Claudia Deckers; Javier Delgado Obando; Shaneel Deo; Niklas Deventer; Claudia Di Bella; Gregory Domson; Davide Maria Donati; Desiree M. Dorleijn; Jacques Du Toit; Debra Dunne; Rodolfo Duran Ciarrochi; Elina Ekman; Ahmed M. El Ghoneimy; Makoto Endo; Levent Eralp; Mahmoud Etaiwi; Scott Evans; Robin Evrard; Will Eward; Alberto Farese; Peter C. Ferguson; Pedro Filipe Ferreira Cardoso; Fabrice Fiorenza; Michael Flint; Hector Flores; Joao Freitas; Bruno Fuchs; Tomohiro Fujiwara; Philipp T. Funovics; Marcos Galli Serra; Zakareya Gamie; Carlos Garces-Zarzalejo; Aaron Gazendam; Carsten Gebert; Jasper G. Gerbers; Craig Gerrand; Michelle Ghert; Kanishka M. Ghosh; Max Gibbons; Anne Gomez-Mascard; Luis Carlos Gomez-Mier; Jesus Gomez-Vallejo; Marcos R. Gonzalez; Fausto Gonzalez-Lizan; Georg Gosheger; Stuart Goudie; Krista Goulding; Stavros D. Goumenos; Anthony Griffin; Ashish Gulia; Sanjay Gupta; Amit Gupta; Maurice Guzman; Mohammed Haitham; Jendrik Hardes; Francisco Hardoy; Yusuf Hasan; Georg Hauer; Helard Havard; Rex Haydon; John Healey; Nerea Hernandez Gonzalez; Adriana Hernandez-Lopez; Asle Hesla; Matthew Hess; Thomas Hilton; Chindanai Hongsaprabhas; Francis Hornicek; Keith Hosking; Eleanor Houghton; Oluwaseyi K. Idowu; Joseph Ippolito; Marc Isler; Shintaro Iwata; Jake Jagiello; Neil Jenkins; Tom Jeys; Charlotte Jeys; Luke Johnson; Andy Johnston; Min Wook Joo; Paul C. Jutte; Kadri Kaldas; Amar Kamat; Sudhir Kannan; Bilal Kapanci; Zeeshan Khan; Hiroshi Kobayashi; Yehuda Kollender; Sebastian Koob; Daniel Kotrych; Richard Kyte; Jose Maria Lamo de Espinosa Vazquez de Sola; Alexander L. Lazarides; Louis-Romee Le Nail; Pawel Legosz; Burkhard Lehner; Andreas Leithner; Maryse Lejoly; Valerae O. Lewis; Peng Lin; Francisco Linares; Santiago Lozano-Calderon; Ashish Mahendra; Ferdiansyah Mahyudin; Fermin Julian Mandia Mancebo; Sara Martos Torrejon; Christian Marx; Eric Mascard; Jean-Camille Mattei; Louise McCullough; Sam McMahon; Manuel Ricardo Medellin Rincon; Benjamin Miller; Shinji Miwa; Gustavo Molina Uribe; Bryan Moon; Diego Jesus Moriel Garcesco; Carol Morris; Stewart Morrison; Sophie Mottard; Marcio Moura; Linde Muster; Robert Nakayama; Prashant Narhari; Ana Navas; Prakash Nayak; Johannes Neugebauer; Erik T. Newman; Jyrki Nieminen; Emmy Nyqvist; Lukas Nystrom; Sarah O'Reilly-Harbidge; Gary O'Toole; Vania Oliveira; André Olivier; Mohamed Omar; Eduardo J. Ortiz-Cruz; Harzem Ozger; Korhan Ozkan; Elisa Pala; Emanuela Palmerini; Grant Pang; Panayiotis Papagelopoulos; Giovanni Paraliticci; Michael C. Parry; Sam Patton; David Peake; Ana Peiro Ibanez; Israel Perez Munoz; Ganapathy Raman Perianayagam; Michael Mork Petersen; Joris Ploegmakers; Robin Pollock; Gerard Powell; Juan Pretell; Jan Puetzler; Faisal Qamar; Anand Raja; Raja Bhaskara Rajasekaran; Dipak B. Ramkumar; R. Lor Randall; Kenneth S. Rankin; Kevin A. Raskin; Kumaran Rassppan; Lauris Repsa; Mickael Ropars; Peter Rose; Wael Sadek; German Salcedo; Aasim Saleemi; Andrea Sambri; Hartej Sar; Roberto Scanferla; Thomas Schubert; Jan Schwarze; Guido Scoccianti; Ashley Scrimshire; Tetsuya Sekita; Ahmad Shehadeh; Ahmed Shoaib; Bhim Shreemal; Felix Shumelinsky; Geoffrey Siegel; Claudio Silveri; Robert Silverwood; Friedl Sinnaeve; Jerome Sison; Andrea Slade; Maria Anna Smolle; Franz Snyman; Scott Sommerville; Sahil Sood; Andre Spiguel; Hugo St-Yves; Eric L. Staals; Silvia Stacchiotti; Nikolaos Stavropoulos; Peter Steadman; Jonathan D. Stevenson; Mikaela Sullivan; Gwen Sys; Bartlomiej Szostakowski; Angela Tamburini; Yuta Taniguchi; Thomas Temple; Christoph Theil; Joachim Thorkildsen; Meagan Tibbo; Roger Tillman; Yu Toda; Kaspar Tootsi; Ferran Torner Rubies; Frank Traub; Ioannis Trikoupis; Panagiotis Tsagkozis; Kim Tsoi; Hiroyuki Tsuchiya; Veli-Matti Vainio; Antonio Valcarcel; Juan Valencia; Annelies Van Beeck; Michel Van de Sande; Thomas Van Den Berghe; Ingrid Van der Geest; Lizz Van der Heijden; Robert Van der Wal; Kirsten Van Langevelde; Gualter Vaz; Roberto Velez Villa; Floortje Verspoor; Koenraad Verstraete; Julia Visgauss; Oleg Vyrva; Hazem Wafa; Sebastian Walter; Wan Faisham Wan Ismail; Edward Wang; Patrick Qi Wang; David Warnock; Joel Werier; Wolfram Weschenfelder; Kwok-Chuen Wong; Marjan Woulthuyzen-Bakker; Jay Wunder; Indica Wysinghe; Norio Yamamoto; Zhaoming Ye; Seung-Jae Yoon; Suraya Zainul Abidin; Tomas Zamora; Pierluca Zecchetto; Liuzhe Zhang; Juan Pablo Zumarraga

doi:10.1302/0301-620X.107B12.BJJ-2024-1039.R4

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A modified Delphi consensus on periprosthetic infection in orthopaedic oncology : a report from the Birmingham Orthopaedic Oncology Meeting (BOOM)

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Peer reviewed

A modified Delphi consensus on periprosthetic infection in orthopaedic oncology : a report from the Birmingham Orthopaedic Oncology Meeting (BOOM)

Lee Jeys, Eduardo Botello, Richard A. Boyle, Walid Ebeid, Matthew T. Houdek, Vineet J. Kurisunkal, Rhidian Morgan-Jones, Guy V. Morris, Ajay Puri, Pietro Ruggieri, …

The bone & joint journal, Vol.107-B(12), pp.1352-1359

2025

DOI: https://doi.org/10.1302/0301-620X.107B12.BJJ-2024-1039.R4

Appears in Miller School of Medicine - Latest Publications

Abstract

Prosthesis-Related Infections/therapy/prevention & control/etiology

Humans

Delphi Technique

Consensus

Antibiotic Prophylaxis

Anti-Bacterial Agents/therapeutic use

Reoperation

Debridement

Orthopedics

AIMS: The aim of this study was to achieve consensus for important topics related to periprosthetic infection (PJI) in orthopaedic oncology, and to identify areas for future research. METHODS: In January 2024, the Birmingham Orthopaedic Oncology Meeting (BOOM) held in Birmingham, UK, gathered 309 delegates from 53 countries to debate 20 consensus statements on PJI in orthopaedic oncology using a modified Delphi process. RESULTS: Of 20 questions and statements on PJI in orthopaedic oncology, none achieved unanimous consensus, 18 achieved strong consensus, one achieved moderate consensus, and one achieved weak consensus. The statements that reached consensus with notable agreement were on the prophylaxis of infection, management of leaking wounds, and surgical strategies for the treatment of PJI. Short-duration antibiotic prophylaxis was deemed as effective as longer courses for lower-risk reconstructions, and aggressive management was recommended for wounds draining beyond five to seven days to prevent deep infection. Furthermore, single-stage, two-stage, and 1.5-stage revision were recognized as valid strategies, with two-stage revision remaining the most reliable. The statements that did not achieve consensus were on the role of debridement, antibiotics, and implant retention and prolonged antibiotic use post-revision. CONCLUSION: The BOOM meeting achieved consensus for important topics on periprosthetic infection in orthopaedic oncology, but highlighted the low quality of the underlying evidence. This study has provided recommendations for the treatment of leaky wounds, duration of postoperative antibiotic prophylaxis, and choice of revision strategy.

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Title: A modified Delphi consensus on periprosthetic infection in orthopaedic oncology : a report from the Birmingham Orthopaedic Oncology Meeting (BOOM)
Creators: Lee Jeys - Royal Orthopaedic Hospital
Eduardo Botello
Richard A. Boyle - Royal Prince Alfred Hospital
Walid Ebeid
Matthew T. Houdek - Mayo Clinic
Vineet J. Kurisunkal - Royal Orthopaedic Hospital
Rhidian Morgan-Jones
Guy V. Morris - Royal Orthopaedic Hospital
Ajay Puri - Homi Bhabha National Institute
Pietro Ruggieri
BOOM Consensus Meeting Participants
Minna K. Laitinen
Santiago Abad Repiso
Hesham Abdelbary
Alejandro Abiad Mejia
Ahmed A. Abood
Ghaith Abou-Nouar
Juan C. Abril Martin
Ayman Abu Elhamd
Adesegun Abudu
Marthelena Acosta
Keisuke Ae
Manish Agarwal
Vivek Ajit Singh
Toru Akiyama
Jose I. Albergo
John Alexander
Patricio A. Alfaro
Bugra Alpan
Ibrahim Alshaygy
Jose Amaya-Valero
Megan Anderson
Dimosthenis Andreou
Lucas Annabell
Christopher Anthony
Ahmed Aoude
Iraia Arteagoitia-Colino
Apichat Asavamongkolkul
William Aston
Libe Asua Mentxaka
Christine Azzopardi
Thomas Baad-Hansen
Ismail T. Badr
Francisco Baixauli-Garcia
Gavin Baker
Tessa Balach
Giacomo G. Baldi
Janie Barry
Georges Basile
Stefano Bastoni
Mohammad Hardian Basuki
Henrik Bauer
Lee Bayliss
Ricardo G. Becker
Angad Bedi
Joseph Benevenia
Francisco Bengoa
Peter Bergh
Marko Bergovec
Nicholas Bernthal
Odion Binitie
David Boddie
Michele Boffano
Patricia Bonilla Huertas
Anna B. Borgognoni
Rajesh Botchu
Jos Bramer
Harriet Branford-White
Rahat Brar
Demien Broekhuis
Samuel E. Broida
Tymoteusz Budny
Zachary Dc Burke
Jorge Cabrolier
Jorge R. Calvo Tapies
Jose A. Calvo-Haro
Dominico Campanacci
Rodrigo Cardoso
Richard Carey Smith
Pedro I. Carvallo
Nicolas Casales Fresenga
Jose Manuel Casanova
Oscar Ceballos
Juan Luis Cebrian Parra
Laura K. Certain
Sara Chacon Cartaya
Chung Ming Chan
Yoon Joo Cho
Peter Choong
Yang-Guk Chung
Dawid Ciechanowicz
Miguel Angel Clara-Altamirano
David Clever
Sebastian Matheo Colina
Luis Consuegra
Cory Couch
Gillian Cribb
Carlos Cuervo
Laurence A. Cusick
Solomon Dadia
Tanios Dagher
Dietmar Dammerer
Mark Davies
Nerys Davies
Luis Pablo de la Rosa Martino
Francisco Javier de Santos de la Fuente
Marieke de Vaal
Claudia Deckers
Javier Delgado Obando
Shaneel Deo
Niklas Deventer
Claudia Di Bella
Gregory Domson
Davide Maria Donati
Desiree M. Dorleijn
Jacques Du Toit
Debra Dunne
Rodolfo Duran Ciarrochi
Elina Ekman
Ahmed M. El Ghoneimy
Makoto Endo
Levent Eralp
Mahmoud Etaiwi
Scott Evans
Robin Evrard
Will Eward
Alberto Farese
Peter C. Ferguson
Pedro Filipe Ferreira Cardoso
Fabrice Fiorenza
Michael Flint
Hector Flores
Joao Freitas
Bruno Fuchs
Tomohiro Fujiwara
Philipp T. Funovics
Marcos Galli Serra
Zakareya Gamie
Carlos Garces-Zarzalejo
Aaron Gazendam
Carsten Gebert
Jasper G. Gerbers
Craig Gerrand
Michelle Ghert
Kanishka M. Ghosh
Max Gibbons
Anne Gomez-Mascard
Luis Carlos Gomez-Mier
Jesus Gomez-Vallejo
Marcos R. Gonzalez
Fausto Gonzalez-Lizan
Georg Gosheger
Stuart Goudie
Krista Goulding
Stavros D. Goumenos
Anthony Griffin
Ashish Gulia
Sanjay Gupta
Amit Gupta
Maurice Guzman
Mohammed Haitham
Jendrik Hardes
Francisco Hardoy
Yusuf Hasan
Georg Hauer
Helard Havard
Rex Haydon
John Healey
Nerea Hernandez Gonzalez
Adriana Hernandez-Lopez
Asle Hesla
Matthew Hess
Thomas Hilton
Chindanai Hongsaprabhas
Francis Hornicek
Keith Hosking
Eleanor Houghton
Oluwaseyi K. Idowu
Joseph Ippolito
Marc Isler
Shintaro Iwata
Jake Jagiello
Neil Jenkins
Tom Jeys
Charlotte Jeys
Luke Johnson
Andy Johnston
Min Wook Joo
Paul C. Jutte
Kadri Kaldas
Amar Kamat
Sudhir Kannan
Bilal Kapanci
Zeeshan Khan
Hiroshi Kobayashi
Yehuda Kollender
Sebastian Koob
Daniel Kotrych
Richard Kyte
Jose Maria Lamo de Espinosa Vazquez de Sola
Alexander L. Lazarides
Louis-Romee Le Nail
Pawel Legosz
Burkhard Lehner
Andreas Leithner
Maryse Lejoly
Valerae O. Lewis
Peng Lin
Francisco Linares
Santiago Lozano-Calderon
Ashish Mahendra
Ferdiansyah Mahyudin
Fermin Julian Mandia Mancebo
Sara Martos Torrejon
Christian Marx
Eric Mascard
Jean-Camille Mattei
Louise McCullough
Sam McMahon
Manuel Ricardo Medellin Rincon
Benjamin Miller
Shinji Miwa
Gustavo Molina Uribe
Bryan Moon
Diego Jesus Moriel Garcesco
Carol Morris
Stewart Morrison
Sophie Mottard
Marcio Moura
Linde Muster
Robert Nakayama
Prashant Narhari
Ana Navas
Prakash Nayak
Johannes Neugebauer
Erik T. Newman
Jyrki Nieminen
Emmy Nyqvist
Lukas Nystrom
Sarah O'Reilly-Harbidge
Gary O'Toole
Vania Oliveira
André Olivier
Mohamed Omar
Eduardo J. Ortiz-Cruz
Harzem Ozger
Korhan Ozkan
Elisa Pala
Emanuela Palmerini
Grant Pang
Panayiotis Papagelopoulos
Giovanni Paraliticci
Michael C. Parry
Sam Patton
David Peake
Ana Peiro Ibanez
Israel Perez Munoz
Ganapathy Raman Perianayagam
Michael Mork Petersen
Joris Ploegmakers
Robin Pollock
Gerard Powell
Juan Pretell
Jan Puetzler
Faisal Qamar
Anand Raja
Raja Bhaskara Rajasekaran
Dipak B. Ramkumar
R. Lor Randall
Kenneth S. Rankin
Kevin A. Raskin
Kumaran Rassppan
Lauris Repsa
Mickael Ropars
Peter Rose
Wael Sadek
German Salcedo
Aasim Saleemi
Andrea Sambri
Hartej Sar
Roberto Scanferla
Thomas Schubert
Jan Schwarze
Guido Scoccianti
Ashley Scrimshire
Tetsuya Sekita
Ahmad Shehadeh
Ahmed Shoaib
Bhim Shreemal
Felix Shumelinsky
Geoffrey Siegel
Claudio Silveri
Robert Silverwood
Friedl Sinnaeve
Jerome Sison
Andrea Slade
Maria Anna Smolle
Franz Snyman
Scott Sommerville
Sahil Sood
Andre Spiguel
Hugo St-Yves
Eric L. Staals
Silvia Stacchiotti
Nikolaos Stavropoulos
Peter Steadman
Jonathan D. Stevenson
Mikaela Sullivan
Gwen Sys
Bartlomiej Szostakowski
Angela Tamburini
Yuta Taniguchi
Thomas Temple
Christoph Theil
Joachim Thorkildsen
Meagan Tibbo
Roger Tillman
Yu Toda
Kaspar Tootsi
Ferran Torner Rubies
Frank Traub
Ioannis Trikoupis
Panagiotis Tsagkozis
Kim Tsoi
Hiroyuki Tsuchiya
Veli-Matti Vainio
Antonio Valcarcel
Juan Valencia
Annelies Van Beeck
Michel Van de Sande
Thomas Van Den Berghe
Ingrid Van der Geest
Lizz Van der Heijden
Robert Van der Wal
Kirsten Van Langevelde
Gualter Vaz
Roberto Velez Villa
Floortje Verspoor
Koenraad Verstraete
Julia Visgauss
Oleg Vyrva
Hazem Wafa
Sebastian Walter
Wan Faisham Wan Ismail
Edward Wang
Patrick Qi Wang
David Warnock
Joel Werier
Wolfram Weschenfelder
Kwok-Chuen Wong
Marjan Woulthuyzen-Bakker
Jay Wunder
Indica Wysinghe
Norio Yamamoto
Zhaoming Ye
Seung-Jae Yoon
Suraya Zainul Abidin
Tomas Zamora
Pierluca Zecchetto
Liuzhe Zhang
Juan Pablo Zumarraga
Publication Details: The bone & joint journal, Vol.107-B(12), pp.1352-1359
Publisher: Jeys et al; England
Comment: LR: 20251130; CI: © 2025; JID: 101599229; 0 (Anti-Bacterial Agents); 2025/12/01 00:31 [medline]; 2025/12/01 00:30 [pubmed]; 2025/11/30 19:03 [entrez]; AID: BJJ-2024-1039.R4 [pii]; epublish
Academic Unit: Miller School of Medicine; UMMG Dept of Medicine - Hematology/Oncology
Language: English
Resource Type: Journal article
Record Identifier: 991032904214802976