Novel strategies to diagnose prosthetic or native bone and joint infections

Belkum, Alex van; Gros, Marie-Françoise; Ferry, Tristan; Lustig, Sébastien; Laurent, François; Durand, G.; Jay, Corinne; Rochas, Olivier; Ginocchio, Christine C.

doi:10.1080/14787210.2021.1967745

Cited by 7 publications

(2 citation statements)

References 182 publications

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“…Until recently, infected bone nonunion remains a huge challenge than common nonunion, requiring radical debridement, susceptible antibiotic treatment, and suitable fixation ( 13 ). Lots of novel biological techniques have been performed in the preclinical studies of bone and joint infectious diseases ( 14 , 15 ). Novel anti-infectious biomaterials mainly focused on the coating technique on scaffold biomaterials ( 16 ) or multiple antibiotics delivery system investigations ( 17 ).…”

Section: Discussionmentioning

confidence: 99%

Masquelet technique with radical debridement and alternative fixation in treatment of infected bone nonunion

et al. 2022

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BackgroundInfected bone nonunion is the toughest problem in fracture-related infection, leading to high disability and recurrence. The aim of this study was to evaluate the effectiveness of the Masquelet technique with radical debridement and alternative fixation in the management of infected bone nonunion.Patients and MethodsA retrospective study of prospectively collected data in two trauma centers was performed from 2016 to 2020. Patients diagnosed as infected bone nonunion were included in this study. The initial implant was removed and all patients received a two-stage Masquelet procedure with radical debridement and alternative fixation. The disappearance of inflammatory manifestations and regression of infection indicators (such as interleukin-6 (IL-6), C-reactive protein, white blood cell count) to the normal range were regarded as radical debridement. The alternative fixation depended on local soft tissue conditions. Results were evaluated according to clinical and radiographic assessment and patient satisfaction.ResultsA total of 23 patients were included in our study. Six of them received internal fixation, while the other 17 received external fixation. Of the 23 cases, 21 were successfully reconstructed without infection recurrence, except 2 reinfected cases. Mean full weight bearing time was 6.6 months follow-up post last surgery. Out of the 23, 20 cases had satisfactory functional outcomes without additional bone or soft tissue comorbidities. Discrepancies in leg length and joint stiffness were observed in three cases and marked as unsatisfied results.ConclusionsInfected bone nonunion can be successfully managed using the Masquelet technique under radical debridement combined with an alternative fixation method.

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Section: Discussionmentioning

confidence: 99%

Masquelet technique with radical debridement and alternative fixation in treatment of infected bone nonunion

et al. 2022

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“…Molecular diagnostic techniques may have a complementary role in traditional microbiology. 8 , 9 The commercial BioFire Joint Infection (JI) panel (BioFire; bioMérieux, USA) uses a multiplex polymerase chain reaction (PCR)-based approach and provides rapid identification in synovial fluid of 31 clinically relevant PJI microorganisms, as well as eight antimicrobial resistance markers. 10 …”

Section: Introductionmentioning

confidence: 99%

The role of BioFire Joint Infection Panel in diagnosing periprosthetic hip and knee joint infections in patients with unclear conventional microbiological results

Gardete-Hartmann,

Mitterer,

Sebastian

et al. 2024

Bone Joint Res

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AimsThis study aimed to evaluate the BioFire Joint Infection (JI) Panel in cases of hip and knee periprosthetic joint infection (PJI) where conventional microbiology is unclear, and to assess its role as a complementary intraoperative diagnostic tool.MethodsFive groups representing common microbiological scenarios in hip and knee revision arthroplasty were selected from our arthroplasty registry, prospectively maintained PJI databases, and biobank: 1) unexpected-negative cultures (UNCs), 2) unexpected-positive cultures (UPCs), 3) single-positive intraoperative cultures (SPCs), and 4) clearly septic and 5) aseptic cases. In total, 268 archived synovial fluid samples from 195 patients who underwent acute/chronic revision total hip or knee arthroplasty were included. Cases were classified according to the International Consensus Meeting 2018 criteria. JI panel evaluation of synovial fluid was performed, and the results were compared with cultures.ResultsThe JI panel detected microorganisms in 7/48 (14.5%) and 15/67 (22.4%) cases related to UNCs and SPCs, respectively, but not in cases of UPCs. The correlation between JI panel detection and infection classification criteria for early/late acute and chronic PJI was 46.6%, 73%, and 40%, respectively. Overall, the JI panel identified 12.6% additional microorganisms and three new species. The JI panel pathogen identification showed a sensitivity and specificity of 41.4% (95% confidence interval (CI) 33.7 to 49.5) and 91.1% (95% CI 84.7 to 94.9), respectively. In total, 19/195 (9.7%) could have been managed differently and more accurately upon JI panel evaluation.ConclusionDespite its microbial limitation, JI panel demonstrated clinical usefulness by complementing the traditional methods based on multiple cultures, particularly in PJI with unclear microbiological results.Cite this article: Bone Joint Res 2024;13(7):353–361.

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Cutibacterium acnes clonal complexes display various growth rates in blood culture vials used for diagnosing orthopedic device-related infections

et al. 2021

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Novel strategies to diagnose prosthetic or native bone and joint infections

Cited by 7 publications

References 182 publications

Masquelet technique with radical debridement and alternative fixation in treatment of infected bone nonunion

Masquelet technique with radical debridement and alternative fixation in treatment of infected bone nonunion

The role of BioFire Joint Infection Panel in diagnosing periprosthetic hip and knee joint infections in patients with unclear conventional microbiological results

Cutibacterium acnes clonal complexes display various growth rates in blood culture vials used for diagnosing orthopedic device-related infections

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