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Reply to the Letter to the Editor: New Definition for Periprosthetic Joint Infection: From the Workgroup of the Musculoskeletal Infection Society

Parvizi, Javad MD, FRCS1,a

Clinical Orthopaedics and Related Research®: January 2017 - Volume 475 - Issue 1 - p 291–291
doi: 10.1007/s11999-016-5088-5
Reply to the Letter to the Editor

1Department of Orthopaedic Surgery, Rothman Institute at Thomas Jefferson University, 925 Chestnut Street, 19107, Philadelphia, PA, USA


Received September 9, 2016/Accepted September 12, 2016; previously published online October 31, 2016

(RE: Parvizi J, Zmistowski B, Berbari EF, Bauer TW, Springer BD, Della Valle CJ, Garvin KL, Mont MA, Wongworawat MD, Zalavras CG. New definition for periprosthetic joint infection: From the Workgroup of the Musculoskeletal Infection Society. Clin Orthop Relat Res. 2011;469:2992-2994.).

The author certifies that he, or a member of his immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and RelatedResearch® editors and board members are on file with the publication and can be viewed on request.

The opinions expressed are those of the writers, and do not reflect the opinion or policy of CORR® or The Association of Bone and Joint Surgeons®.

To the Editor,

I would like to thank Metsemakers and colleagues for their insightful letter related to our article published in 2011, introducing the Musculoskeletal Infection Society's (MSIS) definition of periprosthetic joint infection (PJI). As the authors correctly point out, the definition introduced by the MSIS was the result of a consensus reached among a group of experts that was convened at the time. A further consensus meeting in 2013 endorsed the MSIS definition of PJI and altered it slightly [1].

The authors of the letter are generous with their comments. I agree that the introduction of a “standard” definition of PJI has brought some harmony into a field that suffered much variability. I also agree wholeheartedly with the authors that such initiative in the field of trauma, and for that matter, other orthopaedic subspecialties such as shoulder and elbow surgery, is desperately needed. The proposal by the authors to convene a workgroup to address issues related to infection occurring after trauma, including a definition for infected nonunion, for example, is outstanding.

In fact, during the last consensus meeting on PJI in 2013, the need to extend the consensus workgroup to include other subspecialties was discussed. Heeding that recommendation by some of the delegates, the next consensus meeting that will be held in 2018 intends to convene a group of experts in the field of trauma, shoulder and elbow, foot and ankle, spine, and oncology to address the subspecialty specific questions. We very much hope that the authors of this letter will consider joining that consensus meeting to accomplish the much needed task that they have elegantly outlined.

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1. Cats-Baril W, Gehrke T, Huff K, Kendoff D, Maltenfort M, Parvizi J. International consensus on periprosthetic joint infection: Description of the consensus process. Clin Orthop Relat Res. 2013;471:4065-4075 10.1007/s11999-013-3329-43825924.
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