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Orthopaedic Proceedings
Vol. 105-B, Issue SUPP_17 | Pages 7 - 7
24 Nov 2023
Martos MS Boadas L Trebse R Marais L Ruiz PS Vaznaisiene D Grenho A Ferrari MC Soriano A
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Aim

Two-stage replacement is a frequent procedure in patients with chronic PJI. However, results in the literature after this procedure differ, ranging from 54% to 100% of infection eradication. Positive cultures at reimplantation, when performing the second stage, are perceived as a risk factor for reinfection. This study aims to determine the impact of positive cultures during the second stage on the outcome of patients undergoing a 2-stage septic replacement and the impact of antibiotic holidays between the first and the second stage.

Method

We systematically searched four databases from inception to May 31, 2022. We combined terms related to PJI, joint replacement and culture results. We analysed the risk of failure when positive cultures at second stage and performed a subgroup analysis by antibiotic holiday period.


Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_17 | Pages 1 - 1
1 Dec 2018
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
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
Full Access

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 1 - 1
1 Dec 2017
Vaznaisiene D Sulcaite R Jomantiene D Beltrand E Spucis A Reingardas A Kymantas V Mickiene A Senneville E
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Aim

To assess the spread of foot infection and its impact on the outcomes of major amputations of lower extremities in diabetic patients.

Method

In a multicentre retrospective and prospective cohort study, we included adult diabetic patients (≥ 18 years) who underwent a major amputation of a lower limb in 5 hospitals between 2000 and 2009, 2012 and 2014. A total of 51 patients were included (of which 27 (52.94%) were men and 24 (47.06%) were women) with the mean age of 65.51 years (SD=16.99). Concomitant section's osseous slice biopsy (BA) and percutaneous bone biopsy of the distal site (BD) were performed during limb amputation. A new surgical set-up and new instruments were used to try and reduce the likelihood of cross-contamination during surgery. A positive culture was defined as the identification of at least 1 species of bacteria not belonging to the skin flora or at least 2 bacteria belonging to the skin flora (CoNS (coagulase negative staphylococci), Corynebacterium spp, Propionibacterium acnes) with the same antibiotic susceptibility profiles. A doubtful culture was defined as the identification of 1 species of bacteria belonging to the skin flora. The patients were followed-up for 1 year. Stump outcomes were assessed on the delay of complete healing, equipment, need of re-intervention and antibiotics.