Chronic PJIs
Conditions
Keywords
bone and joint infection, biofilm, joint arthroplasty, implant failure, prosthetic joint infection, dithiothreitol
Brief summary
Prosthetic joint infections (PJIs) are one of the main causes of implant failure after joint arthroplasty. Identification of the causal organism is crucial for successful treatment. However, microbiological diagnosis of PJIs remains a challenge notably because bacteria are embedded in biofilm adhered to the material. Recently, dithiothreitol (DTT) treatment of prosthesis has been proposed as a new strategy to dislodge bacteria from biofilm, thus becoming an alternative to sonication to improve the yield of the microbiological diagnosis. In this study, the investigators evaluate the interest of a commercial device using DTT, the MicroDTTect system (Heraeus, Hanau, Allemagne), for the diagnosis of low-grade chronic PJIs compared to the conventional culture of periprosthetic tissue (PPT) samples.
Detailed description
Prosthetic joint infections (PJIs) are one of the main causes of implant failure after joint arthroplasty. Identification of the causal organism is crucial for successful treatment. However, microbiological diagnosis of PJIs remains a challenge notably because bacteria are embedded in biofilm adhered to the material. Recently, dithiothreitol (DTT) treatment of prosthesis has been proposed as a new strategy to dislodge bacteria from biofilm, thus becoming an alternative to sonication to improve the yield of the microbiological diagnosis. In this study, the investigators evaluate the interest of a commercial device using DTT, the MicroDTTect system (Heraeus, Hanau, Allemagne), for the diagnosis of low-grade chronic PJIs compared to the conventional culture of periprosthetic tissue (PPT) samples.
Interventions
BIOLOGICALCulture of removed prosthesis using DTT
No specific or supplementary intervention is performed among patients. The included patients have scheduled surgery consisting of prosthesis removal or change. Instead of being discarded, the prosthesis which was removed during the surgery was sent to the laboratory using the MicroDTTect system and bacterial culture was performed with the fluid obtained. Results will be then compared to classical culture of periprosthetic tissues (PPT).
Sponsors
Hospices Civils de Lyon
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Adult patients with painful prosthesis or prosthesis loosening \<10 years * without mechanical explanation, * without clinical evidence of infection (no fistula, no abscess, no discharge, no local inflammation), * without microbiological diagnosis (absence of preoperative joint puncture (not performed or not feasible) or with a culture-negative preoperative joint puncture).
Exclusion criteria
Patients with painful prosthesis or prosthesis loosening * with mechanical explanation, * or with clinical evidence of infection (fistula, abscess, discharge, local inflammation), * with a previous microbiological diagnosis
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rate of bacteria isolated isolated | every day until 15 days of culture | type of bacteria isolated |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| time to positivity of cultures | every day until 15 days of culture | time to positivity of cultures of the fluid obtained after prosthesis treatment using the MicroDTTect system in comparison with conventional culture of PPT samples |
Countries
France
Outcome results
None listed