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Orthopaedic Proceedings
Vol. 105-B, Issue SUPP_17 | Pages 3 - 3
24 Nov 2023
Dinh A Chatillon ED Ho R McNally M Dudareva M Scarborough M Jesuthasan G Escolà-Vergé L Lora-Tamayo J Mancheño-Losa M Thill P Giordano G Fourcade C Duran C Bonnet E Hascoet JL
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Aim

Prosthetic joint infection (PJI) due to Candida spp. is a severe complication of arthroplasty but is little reported. This study describes Candida PJI epidemiology, management, and outcome.

Method

We performed a retrospective, observational multinational study with support of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID). Patients diagnosed with PJI due to Candida spp. between 1990 and 2021 were included. Demographic, clinical, laboratory, imaging, medical/surgical treatment, and outcome data were collected within a standardized database. Treatment failure was defined either as a Candida infection recurrence, superinfection, or death due to infection.


Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_14 | Pages 49 - 49
1 Dec 2019
Giordano G Krin G Portet Y Bouige A Fourcade C Bonnet E
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Aims

To evaluate the place of the massive prostheses in the most complex periprosthetic infections cases (PJis).

Method

Between 2011 and 2017, 516 hip and knee revisions for periprosthetic infections had been performed in our hospital by the same senior surgeon. We report a prospective series of 58 patients treated between 2011 and the end of 2017. 26 males and 32 females with on average 69,4 years old (38–86). Infection involved TKA in 39 cases (26 TKA revisions, 11 primary TKA), THA in 18 cases (10 revisions, 7 primary THA), a femoral pseudoarthrosis with posttraumatic gonarthrosis in one case and a septic humeral pseudoarthrosis in one case.

We used one stage procedures in 38 cases (14 hips, 23 knees, 1 shoulder) and 20 two stages surgeries (16 knees and 4 hips). Additional technics used with massive prostheses, all for TKA PJis: 4 massive extensor systemallografts performed two times in a one stage procedure, two local flaps (medial gastronecmienmuscle). Two perioperative hyperbaric procedures used to limit the risks of wound complications.


Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_17 | Pages 31 - 31
1 Dec 2018
Bonnet E Limozin R Giordano G Fourcade C
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Aim

The aim of our study was to identify pathogens involved in septic knee arthritis after ACLR and to describe clinical features, treatment and outcome of infected patients.

Methods

We conducted a retrospective observational study including all patients with ACLR infection in 3 orthopedic centers sharing the same infectious disease specialists.


Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_22 | Pages 86 - 86
1 Dec 2017
Fourcade C Aurelie B Labau E Giordano G See AB Bonnet E
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Aim

In private healthcare facilities, the access to a specialized infectious disease (ID) advice is difficult. More, the lack of traceability is problematic and harmful for treatment and follow-up. We have tested an information technology (IT) application to improve medical transmission and evaluate an interdisciplinary ID activity.

Methods

In November 2015, three ID physicians (IDP) created an interdisciplinary activity, visiting patients and giving phone advices among ten private healthcare facilities. They are members of the complex bone and joint infection unit of the community hospital where they are attached. Since September 2016, each advice was prospectively recorded on a protected online information system. These data are available for consultation and modification by the three IDP. It is the first descriptive analysis of this database.


Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_22 | Pages 32 - 32
1 Dec 2017
Bicart-Sée A Bouige A Fourcade C Krin G Arnaud S Conte P Félicé M Bonnet E Giordano G Rottman M
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Aim

Pre-operative distinction between prosthetic joint infections (PJI) and non-infectious causes of joint failure is particularly challenging, especially in chronic situations. Guidelines propose different algorithms using numerous preoperative tests. We evaluated place of serology.

Method

During a 9 month period, we included consecutive patients undergoing arthroplasty revision for a suspected chronic hip or knee infection. Serologies were sampled at the same day than the other blood tests. Results were compared with the final diagnosis, determined with peroperative bacteriological and histological results.

Serology was performed using a multiplex antibody detection*. This multiplex antibody detection assay detects antibodies against Staphylococcus species, Propionibacterium acnes and Streptococcus agalactiae.


Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_22 | Pages 37 - 37
1 Dec 2017
Fourcade C Aurelie B See AB Giordano G Bonnet E
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Aim

European population is ageing concurrently with an increase number of arthroplasties. Prosthetic joint infection (PJI) in the elderly is considered more severe. The aim of this study is to describe PJI's management of patients over 79 years of age.

Methods

We conducted a retrospective study including all patients aged over 79 years old consulting for a suspected hip or knee PJI in our community hospital where a complex bone and joint unit is present.


Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_22 | Pages 6 - 6
1 Dec 2017
Bouige A Fourcade C Bicart-Sée A Félicé M Gautié L Krin G Marlin P Giordano G Bonnet E
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Aim

Ceftobiprole, a broad-spectrum cephalosporin, could be used for post-operative treatment of bone implant-associated infections. The aim of the study is to evaluate the in vitro susceptibility of bacteria isolated from bone implant-associated infections to ceftobiprole.

Method

We conducted an in vitro, retrospective and comparative study between July 2013 to April 2017 including patients with bone implant-associated infections (prosthesis joint infection (PJI) and osteosynthesis material (OM)). To evaluate MIC distribution of ceftobiprole against Gram positive and Gram negative strains and to compare activity of ceftobiprole to vancomycin for Gram positive and ceftriaxone or ceftazidime for Gram negative strains, we tested all strains (stored in Cryobank storage system) for minimal inhibitory concentrations (MIC) determination by E-test bandelet for ceftobiprole and comparator antibiotics.


Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_22 | Pages 82 - 82
1 Dec 2017
Bouige A Fourcade C Bicart-Sée A Félicé M Gautié L Krin G Hascoet JL Marlin P Giordano G Bonnet E
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Aim

Prosthetic joint infections (PJI) due to Enterobacter cloacae are rare and often severe. The aim of this study is to describe cases with E. cloacae PJI.

Method

We conducted a retrospective and a monocentric study in an orthopedic unit where complex bone and joint infections are managed. From 2012 to 2016, we included patients with PJI which perioperative samples were positive with E. cloacae. We collected background, clinical, biological and microbiological data of the current infection, surgical and medical treatment, and the outcome of these patients.


Orthopaedic Proceedings
Vol. 98-B, Issue SUPP_23 | Pages 35 - 35
1 Dec 2016
Fourcade C Gomez-Brouchet A See AB Lourtet-Hascouet J Felice M Giordano G Bonnet E
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Aim

When a prosthetic joint infection (PJI) is suspected, guidelines recommend performing periprosthetic samples, at least one for histopathological examination and 3 to 6 for microbiological culture. The diagnosis of infection is based on the presence of neutrophil granulocytes whose number and morphology can be variable, resulting in definition of “acute” inflammation. The acute inflammation of periprosthetic tissue is supportive of infection. Since 2007, in our hospital, for all patients with suspected PJI who underwent surgery, from each sample taken by the surgeon, one part has been sent to the pathologist and the other one to the microbiologist. Our aim was to compare histopathological to microbiological results from samples taken intraoperatively at the same site.

Method

We conducted a retrospective study including all surgeries for which at least one couple “histopathology-culture” was found. Exclusion criterion was a history of antimicrobial treatment 2 weeks prior the surgery.