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Orthopaedic Proceedings
Vol. 104-B, Issue SUPP_10 | Pages 71 - 71
1 Oct 2022
MANAGEMENT OF HIP AND KNEE PROSTHESIS JOINT INFECTION (PJI) DUE TO S. AUREUS BY THE “DEBRIDEMENT ANTIBIOTICS AND IMPLANT RETENTION” (DAIR) PROCEDURE IN FRENCH REFERENCE CENTRES (CRIOACS) IN 2019: A RETROSPECTIVE COHORT STUDY
Ferry T Arvieux C Stendel E Nich C Delobel P Zeller V Sotto A Dauchy F RONDE-OUSTAU C Tizon A
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Aim

To describe the management of PJI due to S. aureus in CRIOAcs in 2019 and to particularly focus on the evaluation of the efficacy of DAIR regarding control of infection and risk factors for failure up to 12 months.

Method

Thirteen CRIOAcs were selected to participate to the study. Data concerning the management of all the PJI in the year 2019 were retrospectively collected and registered in eCRFs. Inclusion criteria were: ≥ 18 years old patients with S. aureus ± other bacteria (in per surgical procedure sample); knee or hip PJI and with clinical signs of infection. Patients treated with bacteriophages were excluded. All eligible patients were notified by an information letter. Patients treated by the DAIR procedure were selected, and rate of control of infection (no inflammatory local signs or no new surgical procedure or no S. aureus in case of puncture) was analyzed using Kaplan Meier method and risk factors for failure at 12 months were assessed using Cox regression model.

Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_17 | Pages 1 - 1
1 Dec 2018
LATE ACUTE PROSTHETIC JOINT INFECTIONS: SHOULD THE IMPLANT BE REMOVED?
Wouthuyzen-Bakker M Sebillotte M Lomas J Kendrick B Palomares EB Murillo O Parvizi J Shohat N Reinoso JC Sánchez RE Fernandez-Sampedro M Senneville E Huotari K Allende JMB García AB Lora-Tamayo J Ferrari MC Vaznaisiene D Yusuf E Aboltins C Trebse R Salles MJ Benito N Vila A Del Toro MD Kramer T Petersdorf S Diaz-Brito V Tufan ZK Sanchez M Arvieux C Soriano A
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Aim

Late acute prosthetic joint infections (PJI) treated with surgical debridement and implant retention (DAIR) have a high failure rate. The aim of our study was to evaluate treatment outcome in late acute PJIs treated with DAIR versus implant removal.

Method

In a large multicenter study, late acute PJIs were retrospectively evaluated. Failure was defined as: PJI related death or the need for prosthesis removal or suppressive antibiotic therapy because of persistent or recurrent signs of infection. Late acute PJI was defined as < 3 weeks of symptoms more than 3 months after the index surgery.

Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_17 | Pages 92 - 92
1 Dec 2018
CLINICAL OUTCOME AND RISK FACTORS FOR FAILURE IN LATE ACUTE PROSTHETIC JOINT INFECTIONS TREATED WITH DEBRIDEMENT AND IMPLANT RETENTION
Wouthuyzen-Bakker M Sebillotte M Lomas J Taylor A Palomares EB Murillo O Parvizi J Shohat N Reinoso JC Sánchez RE Fernandez-Sampedro M Senneville E Huotari K Allende JB Garcia-Cañete J Lora-Tamayo J Ferrari MC Vaznaisiene D Yusuf E Aboltins C Trebse R Salles M Benito N Vila A Del Toro MD Kramer T Petershof S Diaz-Brito V Tufan ZK Sanchez M Arvieux C Soriano A
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Aim

Debridement, antibiotics and implant retention (DAIR) is the recommended treatment for all acute prosthetic joint infections (PJI). However, the efficacy of DAIR and identification of risk factors for failure in patients with late acute PJI, is not well described.

Method

Patients diagnosed with late acute PJI between 2005 and 2015 were retrospectively evaluated. Late acute PJI was defined as the development of acute symptoms (≤ 3 weeks) occurring ≥ 3 months after arthroplasty. Failure was defined as: i) the need for implant removal, ii) infection related death, iii) the need for suppressive antibiotic therapy due to persistent signs of infection and/or iv) relapse or reinfection during follow-up.

Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_22 | Pages 25 - 25
1 Dec 2017
PROGNOSTIC FACTORS OF STREPTOCOCCAL PROSTHETIC BONE AND JOINT INFECTIONS MANAGED IN REFERENCE CENTRES
Mahieu R Dubee V Ansart S Bernard L Gwenael LM Asseray N Arvieux C Ramanantsoa C Legrand E Abgueguen P
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Aim

The optimal treatment of streptococcal prosthetic joint infections (PJIs) is unclear. Poorer outcome has been associated with Streptococcus agalactiae species, comorbidities and polyethylene exchange for conservative approach. Rifampicin use may be associated with higher remission rate but results are sparse.

Method

A cohort of streptococcal PJI (including total hip arthroplasty –THA- or total knee arthroplasty –TKA-) was prospectively created and retrospectively reviewed in 7 reference centers for management of complex PJI between January 1, 2010 and December 31, 2012.

Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_III | Pages 304 - 305
1 Mar 2004
O2281 VALUE OF PREOPERATIVE INVESTIGATIONS IN DIAGNOSING PROSTHETIC JOINT INFECTION: RETROSPECTIVE COHORT STUDY AND LITERATURE REVIEW
Bernard L LŸbbeke A Feron J Peyramond D Denormandie P Arvieux C Chirouze C Hoffmeyer P
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Aims: The diagnosis of a prosthetic joint infection is difþcult, but crucial for appropriate treatment. Scintigraphy with speciþc markers for infection (labeled white cells or immunoglobulin-G) has been reported as a more reliable diagnostic tool than clinical assessment (fever, þstula), laboratory studies [polynuclear neutrophils blood count (PNC), erythrocyte rate sedimentation (ESR), and C-reactive protein (CRP)], and preoperative aspiration. Methods: In the þrst part of this study, we retrospectively reviewed 230 patients admitted with a suspected prosthetic joint infection and compared the validity of these different diagnostic tools. 209 patients had an infection. Results: Pain, fever, ESR, and PNC are unreliable for identifying occult infection. The presence of a þstula is inconstant, but when present is very reliable to detect infection. Our study revealed sensitivity, speciþcity, positive and negative predictive value as follows: CRP: 97%, 81%, 98%, 71% respectively; aspiration: 82%, 94%, 99%, 43% respectively, and labelled scintigraphy 74%, 76%, 91%, 44% respectively. In the second part, we reviewed 23 articles which included 1,722 prosthetic joints with preoperative evaluation of infection. Conclusions: Both our study and the literature review indicate that CRP and joint aspiration are the best tools to diagnose prosthetic joint infection.