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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 553 - 553
1 Sep 2012
Lustig S Allais E Boisset S Ferry T Tigaud S Neyret P Laurent F
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Introduction

Microbiological diagnosis of bone and joint infections (BJIs) currently relies on standard cultures which are time consuming and lack sensitivity. Various molecular approaches have been described and allowed improvement of BJI diagnosis. This study evaluated for the first time the performance of a DNA microarray-based assay (Prove-it™ Sepsis assay, PISA) for the rapid (<6 hours) detection and identification of 50 different species involved in BJI directly from clinical samples.

Material and methods

We retrospectively selected 130 bone and joint samples (67 synovial fluids and 63 bone biopsies) including 114 positive and 16 negative samples. The microbiological diagnosis had been previously established either by culture(C+, n=53) or by PCR16S and sequencing when culture was negative (C-/PCR+). The positive samples were selected to match the species targeted on the DNA microarray. DNA extraction was performed before proceeding to PISA amplification and hybridization on every selected sample.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 279 - 279
1 Sep 2012
Lustig S Barba N Servien E Fary C Demey G Neyret P
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To our knowledge in medial unicompartmental knee arthroplasty (UKA) no study has specifically assessed the difference in outcome between matched gender groups. Previous unmatched gender studies have indicated more favourable results for women.

Method

2 groups of 40 of either sex was determined sufficient power for significant difference. These consecutively were matched with both the pre-operative clinical and radiological findings. Minimum follow up of 2 years, mean follow-up 5.9 years. Mean age at operation was 71 years.

Results

In both groups, the mean IKS knee and function scores improved significantly (p< 0.001) post operatively. There were no significant differences were between the 2 groups. In both groups mean preoperative flexion was 130 degrees and remained unchanged at final follow-up. No significant differences in preoperative and postoperative axial alignment and in the number of radiolucent lines, between groups.

With component size used there was a significant difference (p < 0.001) between the 2 groups. However the size of the femoral or tibial implant used was significantly related (p< 0.001) to patient height for both sexes. Radiolucent lines were more frequent on the tibial component, but were considered stable with none progressing. No revisions for component failure. 1 patient in each group developed lateral compartment degenerative change.

Male group; one conversion to TKA for undiagnosed pain, three patients underwent reoperation without changing the implant. Female group; no implants were revised, and two patients required a reoperation. Kaplan-Meier 5-year survival rate of 93.46% (84.8; 100) for men and100% for women. The survival rate difference is not significant (p=0.28).


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 552 - 552
1 Sep 2012
Lustig S Laurent F Bouaziz A Blanc-Pattin V Rasigade J Ferry T Tigaud S Neyret P
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Introduction

Rapid identification of bacteria from extemporaneous samples would greatly help management of prosthesis joint infection. The aim of the present retrospective study was to evaluate a new molecular assay (GeneXpert MRSA-SA SSTI (Cepheid)) for detecting Staphylococcus aureus (SA) and methicillin resistance directly from bone and joint samples in less an hour (58 minutes).

Material et method

Retrospective study using 91 frozen samples (76 patients) of joints (n=24), bone biopsies (n=42) and tissue biopsies (n=25):

SA positive samples: n=72 (methicillin susceptible SA (MSSA), n=63; methicillin resistant MRSA, n=9)

SA positive samples: n=19

The results were compared with routine results (culture in solid and liquid medium, identification and susceptibility test) from each participating lab.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 282 - 282
1 Sep 2012
Lustig S Parratte S Servien E Argenson J Neyret P
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Introduction

It is documented in the literature the very good results of lateral unicompartmental knee arthroplasty (UKA) when the standard accepted indications are followed. In our experience these indications can be extended to include post-traumatic osteoarthritis (OA) with malunion secondary to tibial plateau fracture. We report our results concerning 15 UKAs in these particular situations.

Material and methods

From 1985 to 2009, we performed 15 lateral UKAs in 15 patients for post traumatic OA secondary to malunion following a tibial plateau fracture. 7 were female and 8 male. The mean age of the patients at the time of the index procedure was 45±17 years and the mean delay from initial trauma was 5.4 years. The average follow-up was 108 months (range 12–265 months).