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Orthopaedic Proceedings
Vol. 103-B, Issue SUPP_15 | Pages 82 - 82
1 Dec 2021
IS THE EUROPEAN BONE AND JOINT INFECTION SOCIETY DEFINITION OF PERIPROSTHETIC JOINT INFECTION MEANINGFUL IN OUR CLINICAL PRACTICE? A MULTICENTRIC VALIDATION STUDY
Sousa R Ribau A Alfaro P Burch M Ploegmakers J Wouthuyzen-Bakker M Clauss M Soriano A
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Aim

There have been many attempts to define the criteria by which prosthetic joint infection (PJI) is diagnosed. Our aim is to validate the 2021 European Bone and Joint Infection Society (EBJIS) definition of PJI.

Method

This is a multicenter retrospective study of patients who have undergone total hip or knee revision surgery in four different European institutions between 2013–2018. Cases with less than four intraoperative microbiology samples; no preoperative/intraoperative synovial fluid differential leukocyte count or intraoperative histology were excluded. Minimum follow-up of at least two years after revision surgery if no subsequent infection and/or the need for implant removal was also required. All cases were classified using the 2021 EBJIS, the 2018 International Consensus Meeting (ICM) and the 2013 Musculoskeletal Infection Society (MSIS) PJI definitions.

Orthopaedic Proceedings
Vol. 103-B, Issue SUPP_15 | Pages 30 - 30
1 Dec 2021
THE EUROPEAN BONE AND JOINT INFECTION SOCIETY PERIPROSTHETIC JOINT INFECTION DEFINITION IS MORE SENSITIVE AND PERFORMS BETTER IN RULING OUT INFECTION PREOPERATIVELY THAN PREVIOUS DEFINITIONS
Ribau A Alfaro P Burch M Ploegmakers J Wouthuyzen-Bakker M Clauss M Soriano A Sousa R
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Aim

Accurate diagnosis is key in correctly managing prosthetic joint infection (PJI). Our aim is to compare the preoperative performance of three PJI definitions comparing it to definitive postoperative classification.

Method

This is a multicenter retrospective study of patients who have undergone total hip or knee revision surgery in four different European institutions. For this specific study, cases with no preoperative synovial fluid differential leukocyte count and less than four intraoperative microbiology samples were excluded.

Cases were classified using the 2021 EBJIS, the 2018 International Consensus Meeting (ICM) and the 2013 Musculoskeletal Infection Society (MSIS) PJI definitions. Preoperative classification was based on clinical features, inflammatory markers and synovial fluid leukocyte count and microbiology results.

Orthopaedic Proceedings
Vol. 87-B, Issue SUPP_I | Pages 82 - 82
1 Mar 2005
CARPECTOMY: REPORT OF FOUR CASES
García-Arévalo JA Mesa F Alfaro P Maquieira C
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Introduction and purpose: The widespread discredit which beset the resection of the proximal carpal row in the past seems to have disappeared. At present this is considered to be a very useful salvage technique with results which in some cases can surpass those of arthrodesis. This technique has been reported to yield a pain remission rate of 90% with a 20% loss of strength as compared with the contralateral hand.

Materials and methods: We set about analyzing the evolution and results obtained in 4 patients, three male and one female. Three of them were subjected to this procedure to correct a posttraumatic osteoarthritis; the other had an inveterate perilunate dislocation. In all cases the SF-12 health score was used to make an assessment of the functional condition of the patients as well as of their degree of satisfaction.

Results: All four patients expressed a high degree of satisfaction. Three of them do not take painkillers while the fourth – operated on 8 months ago – takes them sporadically. Three lead a normal life, whereas the patient who has had the shortest evolution has resumed work only partially. The loss of force in the operated wrist as compared with the contralateral one is of 19%. ROM at present is 46° for volar flexion, 26° for dorsal flexion, 10° for radial deviation and 15° for ulnar deviation. All of them were able to perform a handgrip correctly.

Conclusions: Carpectomy is a good alternative to wrist arthrodesis since it allows a good ROM and the ensuing loss of strength is moderate.