Mid-term follow-up results after implementing a new strategy for the diagnosis and management of periprosthetic joint infections.

Autor: Birlutiu RM; Lucian Blaga University of Sibiu, Faculty of Medicine Sibiu, Str. Lucian Blaga, Nr. 2A, 550169, Sibiu, Romania. raresmircea@gmail.com., Mihalache M; Lucian Blaga University of Sibiu, Faculty of Medicine Sibiu, Str. Lucian Blaga, Nr. 2A, 550169, Sibiu, Romania., Mihalache P; Lucian Blaga University of Sibiu, Bd-ul. Victoriei, Nr.10, 550024, Sibiu, Romania., Cismasiu RS; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.; FOISOR Clinical Hospital of Orthopedics, Traumatology, and Osteoarticular TB Bucharest, Str. Dionisie Lupu nr. 37, Sector 2, 020021, Bucharest, Romania., Birlutiu V; Lucian Blaga University of Sibiu, Faculty of Medicine Sibiu, Str. Lucian Blaga, Nr. 2A, 550169, Sibiu, Romania.; Academic Emergency Hospital Sibiu - Infectious Diseases Clinic, B-dul Corneliu Coposu, Nr.2-4, 550245, Sibiu, Romania.
Jazyk: angličtina
Zdroj: BMC infectious diseases [BMC Infect Dis] 2021 Aug 12; Vol. 21 (1), pp. 807. Date of Electronic Publication: 2021 Aug 12.
DOI: 10.1186/s12879-021-06407-x
Abstrakt: Background: Periprosthetic joint infections (PJIs) represent one of the most serious complications associated with joint replacement surgeries, a complication also of modern orthopedic surgery despite the efforts that occurred in this field. Frequently PJIs lead to prolonged morbidity, increased costs and mortality.
Methods: We are conducting a single-center observational cohort ongoing study in the Academic Emergency Hospital Sibiu, Romania, study in which sonication of the retrieved and as a rapid method of bacteria detection, molecular identification of bacteria by 16S rRNA beacon-based fluorescent in situ hybridization (bbFISH) are used.
Results: A total of 61 patients were enrolled in this study. The diagnosis of aseptic loosening was established in 30 cases (49.1%) and the diagnosis of periprosthetic joint infection was established at 31 patients (50.8%). The mean follow-up period in the subgroup of patients diagnosed with periprosthetic joint infections was 36.06 ± 12.59 months (range: 1-54). The 25-months Kaplan-Meier survival rate as the end point, as a consequence of the period of enrollment and a different follow-up period for each type of surgical procedure, was 75% after debridement and implant retention, 91.7% after one-stage exchange, 92.3% after two-stage exchange, and 100% after three-stage exchange. There were no significant differences in survival percentage.
Conclusions: Our study has good results similar to previously published data. We cannot recommend one strategy of managing prosthetic joint infections over the other. Definitely, there is a need for prospective randomized controlled trials.
(© 2021. The Author(s).)
Databáze: MEDLINE
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