Heraeus MicroDTTect Lyon Pilot Studyprosthetic Joint Infections (PJIs)

Completed

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.

Recruitment & Eligibility

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

Arm && Interventions

Group	Intervention	Description
Patients suspected of low-grade PJIs	Culture of removed prosthesis using DTT	Adult patients suspected of low-grade PJIs, who have a scheduled prosthesis removal or change and who meet the inclusion criteria

Primary Outcome Measures

Name	Time	Method
Rate of bacteria isolated isolated	every day until 15 days of culture	type of bacteria isolated

Secondary Outcome Measures

Name	Time	Method
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

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