Title :

The benefits of systematic intraoperative sampling during lower limb arthroplasties due to sequelae from prior osteoarticular infections: A retrospective study of 92 cases

Author(s) :

Mainard, Nicolas [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Saab, Marc [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Dartus, Julien [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Martinot, Pierre [Auteur]
Loiez, Caroline [Auteur]
Titecat, Marie [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Dezeque, Henri [Auteur]
Putman, Sophie [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Senneville, Eric [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Migaud, Henri [Auteur]
Marrow Adiposity & Bone Lab - Adiposité Médullaire et Os - ULR 4490 [MABLab]

Journal title :

Orthopaedics & Traumatology: Surgery & Research

Abbreviated title :

Orthop Traumatol Surg Res

Volume number :

108

Pages :

103189

Publication date :

2022-04

ISSN :

1877-0568

English keyword(s) :

Osteoarticular infection
Septic arthritis
Periprosthetic joint infection
Arthroplasty
Reinfection

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Introduction Osteoarticular infections (OAIs) of native joints lead to cartilage damage which may require subsequent arthroplasty. There is no consensus on systematic intraoperative microbiological sampling when performing ...
Show more >Introduction Osteoarticular infections (OAIs) of native joints lead to cartilage damage which may require subsequent arthroplasty. There is no consensus on systematic intraoperative microbiological sampling when performing an arthroplasty on a native joint with a history of OAI. We carried out a retrospective study to: (1) identify the frequency of the persistence of the microorganism(s) involved during the initial, presumed cured OAI, when performing an arthroplasty for sequelae of osteoarthritis, (2) to find an association between the length of time between the OAI and arthroplasty, and the recurrence of bacterial infection, (3) to assess the influence of the presence of hardware on the risk of infectious recurrence. Hypothesis Systematic sampling is justified during a subsequent arthroplasty after an OAI, even after a prolonged period. Material and method This single-center, retrospective descriptive study included all patients whose indication for arthroplasty resulted from osteoarthritis, osteitis or bacterial osteomyelitis of a native joint, or in the aftermath of an infection post osteosynthesis. All patients were considered to have recovered from the initial infection at the time of the arthroplasty. Between 2008 and 2019, 92 patients were included in the study, with an average age of 56.5 years (range: 21–97 years). OAI occurred at a mean age of 35 years (range: 1–84 years). The average time from OAI to implantation was 15 years (range: 1–65 years). The bacteria most frequently found in the initial OAI was Staphylococcus aureus, involved in 35.8% of cases (n = 33/92). Results The intraoperative samples came back positive in 17% of cases (n = 16/92), including 9 positive for the same bacteria as the OAI (56%, n = 9/16). For these 16 cases, the time between the OAI and the arthroplasty was 1 year for 5 patients, between 1 and 15 years for 5 patients and greater than 15 years for 6 patients. For 3 positive patients, the information on the initial microorganism was not known and 4 patients were positive for a bacterium different from the initial one. The time from the initial OAI to the arthroplasty was not associated with positive results (p = 0.38). There was no significant difference between a positive culture at the time of arthroplasty and the initial type of OAI [native joint versus presence of hardware and/or open fracture (p = 0.41)]. Conclusion The results of this work suggest there is value in microbiological sampling when performing an arthroplasty on a previously infected joint, regardless of the duration of the infection.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
CHU Lille

Collections :

• Marrow Adiposity & Bone Lab (MABLab) - ULR 4490
• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2023-11-15T05:19:39Z
2024-02-15T09:10:03Z
2024-02-27T15:27:48Z