[Text on screen: Ohio State Health & Discovery
What Ohio State offers PJI patients]

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[Text on screen: Douglas Chonko, DO
Orthopedic Surgeon
Ohio State Wexner Medical Center]

Douglas Chonko, DO:
One of the unique things that we can offer patients here at the Ohio State University Medical Center is a team approach for the treatment of periprosthetic joint infections. We have a very collaborative team that includes many different specialties when it comes to the treatment of PJI. 

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This is not a disease or a diagnosis that'd be treated by one person. This is something that needs to be treated by a team, and that's what we offer here. Of course, an orthopedic surgeon that specializes in adult reconstruction. Adult reconstruction is hip and knee replacements. Takes call on a weekly basis here. We feel that we're the only medical center in the United States that has a weekly call schedule just dedicated to periprosthetic joint infection diagnosis and treatment. We work very closely with our emergency department. The emergency room physicians will contact our residents and the attendings and make sure that we're seeing these patients in a very timely manner in the emergency department.

Oftentimes, we get inaccurate aspirations and cultures when patients present to many of the emergency departments around the country because one of the earliest things that are given to patients that present with infection symptoms are antibiotics. But unfortunately, when patients come in with an antibiotic or are given one in the emergency department, the ability for us to diagnose and get positive cultures goes down. So we like to see the patients, get an aspiration, interview the patient and see what is their presentation and what their fluid and their hip and their knee appearance is like prior to the start of antibiotics.

There are many other really key components of that team approach. Plastic surgery is included as part of that team. Many patients present with soft tissue loss, with wound dehiscence or the skin is not healing well or it's opening up, and we need the help and the services of what plastic surgery can bring to the table. Oftentimes, plastic surgery will do what is called a muscle flap or they'll transfer muscle from one area close to the hip or the knee and they'll move it directly over the incision or the area where the implant's at. That does a couple of things. It will bring vascularity to the area and it will allow the antibiotics and the immune system to get to that area where the infection is at and help eradicate that infection.

We utilize our hospitalists and our internal medicine specialists. Many of these patients come in and they're very, very sick and they need optimization. Oftentimes, their blood sugars are elevated as a result of that infection. Oftentimes, they have co-morbid diseases, such as renal and liver disease, and we need to make sure that they're optimized at the time that we will take them to surgery, so that we can get the best results from the treatment and the surgery that we're doing. We also include our physical therapy team. 

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That's an important part of this because we want you to recover, get your strength and your balance back. Our pharmacists also are very helpful. We have a program that's called Antimicrobial Stewardship and they work very closely with our infectious disease experts, and together they help to decide what's going to be the best antibiotic, the length of time that you're going to be on that antibiotic and for how long and the best way to get you those types of medications after you leave the hospital.

[Text on screen: Ohio State Health & Discovery
For more information, visit:
wexnermedical.osu.edu/orthopedics]

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